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Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings
Affiliations- Department of Orthopedic Surgery, Multidisciplinary Hospital, Inowrocław, Poland
- Department of Orthopedic Surgery, Orvit Clinic, Toruń, Poland
- Department of Radiology, Multidisciplinary Hospital, Inowrocław, Poland
- Department of Clinical Pathomorphology, Nicolaus Copernicus University, Bydgoszcz, Poland
- Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, Poznan University of Medical Sciences, Poznań, Poland
open access
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.
Keywords
tendinopathy; shoulder joint; biceps tendon
About this articleTitle
Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings
Journal
Issue
Article type
Original article
Pages
583-590
Published online
2018-01-26
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1553
Article views/downloads
1493
DOI
Pubmed
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
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