open access

Vol 77, No 3 (2018)
ORIGINAL ARTICLES
Published online: 2018-01-26
Submitted: 2017-11-01
Accepted: 2018-01-16
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Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings

J. Zabrzyński, Ł. Paczesny, A. Zabrzyńska, D. Grzanka, Ł. Łapaj
DOI: 10.5603/FM.a2018.0012
·
Pubmed: 29399753
·
Folia Morphol 2018;77(3):583-590.

open access

Vol 77, No 3 (2018)
ORIGINAL ARTICLES
Published online: 2018-01-26
Submitted: 2017-11-01
Accepted: 2018-01-16

Abstract

Background: Disorders of the long head of the biceps (LHB) tendon are a common source of shoulder pain and disability. This tendon can be well visualised using ultrasonography; however, little is known if such examination allows clinicians to predict pathological changes of the tendon structure. In the study described below, we compare preoperative sonographic findings with the data from shoulder arthroscopy and microscopic examination of the excised tendon fragments in 19 consecutive patients with LHB tendinopathy and clinical suspicion of its instability.
Materials and methods: Preoperative ultrasonographic (US) inspection assessed several features of the tendon, whereas its stability was verified arthroscopically. In all cases, tenodesis or tenotomy procedures were performed and excised tendon fragments were harvested for microscopic examination based on the semiquantitative Bonar score.
Results: The most common US findings were hypoechoic areas, tendon thickening, an increased power Doppler signal and mechanical instability. Just as shoulder arthroscopy confirmed all mechanical instability cases detected in US, microscopic assessment revealed advanced degeneration in all samples.
Conclusions: Our study indicates that US is a useful tool in identifying cases of advanced instability and LHB tendinopathy, whereas biceps tendon instability is a biomechanically complex, gradually progressing phenomenon, frequently associated with additional shoulder lesions.

Abstract

Background: Disorders of the long head of the biceps (LHB) tendon are a common source of shoulder pain and disability. This tendon can be well visualised using ultrasonography; however, little is known if such examination allows clinicians to predict pathological changes of the tendon structure. In the study described below, we compare preoperative sonographic findings with the data from shoulder arthroscopy and microscopic examination of the excised tendon fragments in 19 consecutive patients with LHB tendinopathy and clinical suspicion of its instability.
Materials and methods: Preoperative ultrasonographic (US) inspection assessed several features of the tendon, whereas its stability was verified arthroscopically. In all cases, tenodesis or tenotomy procedures were performed and excised tendon fragments were harvested for microscopic examination based on the semiquantitative Bonar score.
Results: The most common US findings were hypoechoic areas, tendon thickening, an increased power Doppler signal and mechanical instability. Just as shoulder arthroscopy confirmed all mechanical instability cases detected in US, microscopic assessment revealed advanced degeneration in all samples.
Conclusions: Our study indicates that US is a useful tool in identifying cases of advanced instability and LHB tendinopathy, whereas biceps tendon instability is a biomechanically complex, gradually progressing phenomenon, frequently associated with additional shoulder lesions.

Get Citation

Keywords

tendinopathy; shoulder joint; biceps tendon

About this article
Title

Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings

Journal

Folia Morphologica

Issue

Vol 77, No 3 (2018)

Pages

583-590

Published online

2018-01-26

DOI

10.5603/FM.a2018.0012

Pubmed

29399753

Bibliographic record

Folia Morphol 2018;77(3):583-590.

Keywords

tendinopathy
shoulder joint
biceps tendon

Authors

J. Zabrzyński
Ł. Paczesny
A. Zabrzyńska
D. Grzanka
Ł. Łapaj

References (22)
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