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Keywords:
Musculoskeletal joint, Ultrasound, Technical aspects, Motility
Authors:
G. Azulay1, I. Rossi2, D. Postan1, G. Aguilar1, J. Monres3, M. Brandao4, P. Omoumi5, A. Gonzalez1; 1Buenos Aires/AR, 2Buenos aires /AR, 3Goiania/BR, 4Ribeirao Preto/BR, 5Lausanne/CH
DOI:
10.1594/ecr2014/B-0041
Purpose
To demonstrate the 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 biceps and therefore a greater anisotropy.
FIG1
Fig. 1: Actual Maneuver creates false-positive image. Anatomically the tendon fibers of the proximal biceps tend to curl over the humeral head producing an anisotropic effect with deviation of the ultrasound beam (arrows); producing a false-positive hypoechoic image (circle). The tendon gets closer to the acoustic shadow produced by the coracoid process.
The Mick Jagger position maneuver consists of movements of abduction and rotation associated with other options such as traction,
deep inspiration and anterior glenohumeral rotation.
By doing this we try to lower the humeral head,
flatten the tendon of the biceps in its intrarticular course and expose it as much as possible to the acoustic window between the coracoid and the clavicle.
This position reduces the anisotropic effect (circle) FIG2
Fig. 2: The Mick Jagger Position: exposes anteriorly the intra-articular biceps reducing the anisotropy.