To demonstratethe feasibility of a new dynamic ultrasound manoeuvre,
consisting in abduction and external rotation,
for the visualisation of the intra-articular course of the long biceps tendon above the humeral head to its insertion on the glenoid.
The maneuver used till now to evaluate the tendon consists of putting the arm crossed his back.
This maneuver produces a greater exposure of the supraspinatus,
the biceps and an elevation of the humeral head.
This elevation of the humeral head creates a greater curvatur in the intrarticular...
Methods and materials
A cadaveric study was performed to demonstrate the course of the tendon,
as well as the presence of an acoustic window between the acromio clavicular joint and the coracoid process during the manoeuvre.
A prospective study was performed on 40 asymptomatic subjects of various age,
as well as 10 patients referred for shoulder pain,
in whom a correlation to MRI was also obtained.
Two observers graded the presence of an acoustic window,
as well as the visibility of the biceps tendon on a scale from...
The visibility of the biceps tendon was diagnostic in 83% (n=36) 33 of the 40 asymptomatic subjects.
Type 1: 16 patients
Type 2: 5 patients
Type 3: 12 patients
In the 10 pathologic shoulders,ultrasound demonstrated 4 cases of tendinosis (tendon hypertrophy and/or loss of fibrillar pattern) and 1 synovitis surrounding the intra-articular biceps tendon,
in correlation with MRI
The manoeuvre in abduction external rotation allows the evaluation of the biceps tendon in its intra-articular course to its insertion on the glenoid in up to 83% of subjects (Types 1,2,3) .
A major number of patients should be necessary to reach a better statistical evaluation.
Yablon CM1,Bedi A,Morag Y,Jacobson JA. Ultrasonographyof the shoulder with arthroscopic correlation. Clin Sports Med.2013 Jul;32(3):391-408.
Epub 2013 Apr 29.
Chang KV1,Chen WS2,Wang TG2,Hung CY2,Chien KL3.
Associations of sonographic abnormalities of theshoulderwith various grades ofbicepsperitendinous effusion (BPE).UltrasoundMed Biol.2014 Feb;40(2):313-21.
Epub 2013 Dec 7.
Ultrasound of the Musculoskeletal System
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The efficacy ofultrasoundin the diagnosis of long head...