Internal Derangement of the Shoulder

Musculoskeletal Imaging Volume 2 ◽

10.1093/med/9780190938178.003.0104 ◽

2019 ◽

pp. 165-191

Author(s):

David Brandel ◽

Girish Gandikota

Keyword(s):

Patient Management ◽

Soft Tissues ◽

Biceps Tendon ◽

Anatomic Variations ◽

Glenoid Labrum ◽

General Radiologist ◽

High Prevalence ◽

Biceps Pulley ◽

Long Head ◽

Radiology Trainee

Chapter 104 details the use of routine MRI and MRA to visualize the shoulder, identify normal anatomic variations, and diagnose common abnormalities, particularly those that are relevant to the general radiologist or radiology trainee. Although evaluation of the shoulder begins with radiography, when injury to the soft tissues is suspected, MRI offers numerous advantages. An emphasis will be placed on pathology of the rotator cuff and glenoid labrum, given their high prevalence and importance in patient management. Lesions of the biceps pulley and long head of biceps tendon will also be reviewed. Finally, the spectrum of findings related to muscle denervation will be discussed.

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Attachment Types of the Long Head of the Biceps Tendon to the Glenoid Labrum and Their Relationships with the Glenohumeral Ligaments

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2005.07.006 ◽

2005 ◽

Vol 21 (10) ◽

pp. 1242-1249 ◽

Cited By ~ 50

Author(s):

Yilihamu Tuoheti ◽

Eiji Itoi ◽

Hiroshi Minagawa ◽

Nobuyuki Yamamoto ◽

Hidetomo Saito ◽

...

Keyword(s):

Biceps Tendon ◽

Glenoid Labrum ◽

Glenohumeral Ligaments ◽

Long Head

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Prevalence and Grading of Rotator Cuff and Labral Injuries in Shoulder Pain and Instability using MRI: ACross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48773.14845 ◽

2021 ◽

Author(s):

Ashok Srikar Chowdhary ◽

Naresh Babu Lakshmipathi Nikhil ◽

Nidhi Hemendra Chandrakar ◽

Nidhi Raj Buddaraju

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Biceps Tendon ◽

Supraspinatus Tendon ◽

Sectional Study ◽

Rotator Cuff Injuries ◽

Rotator Cuff Injury ◽

Biceps Pulley ◽

Study Population ◽

Long Head

Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to diagnose and describe the extent of rotator cuff tendon and labral injuries and any secondary rotator cuff muscle abnormalities. Aim: To study the demographic profile of patients presenting with shoulder pain and instability, identify the various rotator cuff injuries causing shoulder pain, identify the rotator cuff interval lesions causing microinstability, identify the various labral and bony pathologies in instability, describe the MRI features of the rotator cuff, rotator cuff interval, labral and bony injuries. Materials and Methods: This study was a cross-sectional study of patients with symptoms of either shoulder pain or instability who underwent MRI evaluation of the shoulder in the Department of Radiodiagnosis, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, from July 2018 to December 2020. The study population consisted of 54 patients with either shoulder pain or instability who underwent MRI of shoulder. All the MRI scans of the shoulder in this study were performed using 1.5 Tesla Siemens Magnetom Avanto (Tim 76x18) MR machine using a flex coil. Results: The study population consisted of 54 patients comprising of 38 males and 16 females. The age of the patients ranged from 20-77 years. Majority of the patients were older than 50 years constituting about 33.33% of the total study population. Rotator cuff injury was the commonest cause of pain. Tendinosis was the commonest type of rotator cuff injury followed by partial-thickness and full-thickness tendon tears. The commonest grade of tendinosis was mild or grade 1. Supraspinatus tendon was the most commonly affected tendon followed by subscapularis and infraspinatus tendons. Teres minor tendon was normal in all the cases. Anterior instability was the commonest type of instability with equal prevalence of soft tissue Bankart, bony Bankart and Perthes lesions. Biceps pulley lesions resulted in long head of biceps tendon instability, microinstability and internal impingement. Conclusion: Rotator cuff injuries are the commonest cause of shoulder pain and are seen more frequently after the fifth decade. Shoulder instability is most commonly seen in young male adults. Tendinosis is the commonest type of rotator cuff injury. Supraspinatus tendon is the most commonly injured tendon. Anterior instability is the commonest type of shoulder instability. Biceps pulley lesions result in long head of biceps tendon instability, microinstability and internal impingement. MRI can diagnose interstitial or intrasubstance tendon tears which are not visualised on arthroscopy. MRI description of tendon and labral tears, tendon retraction and muscle atrophy can guide the orthopaedician during arthroscopy and in treatmentplanning.

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Attachment Types of the Long Head of the Biceps Tendon to the Glenoid Labrum and Their Relationships with the Glenohumeral Ligaments

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/s1551-7977(08)70213-9 ◽

2007 ◽

Vol 2007 ◽

pp. 13-14

Author(s):

T.R. McAdams

Keyword(s):

Biceps Tendon ◽

Glenoid Labrum ◽

Glenohumeral Ligaments ◽

Long Head

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Symptomatic Superior Labral Anterior Posterior Lesion With Absence of the Long Head of the Biceps Tendon: A Case Report

Yearbook of Sports Medicine ◽

10.1016/s0162-0908(08)70296-4 ◽

2006 ◽

Vol 2006 ◽

pp. 60-61

Author(s):

D.E. Feldman

Keyword(s):

Case Report ◽

Biceps Tendon ◽

Posterior Lesion ◽

Long Head ◽

Anterior Posterior

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Measurements of Tendon Movement Within the Bicipital Groove After Suprapectoral Intra-articular Biceps Tenodesis in a Cadaveric Model

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120977538 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097753

Author(s):

Brian J. Kelly ◽

Alan W. Reynolds ◽

Patrick J. Schimoler ◽

Alexander Kharlamov ◽

Mark Carl Miller ◽

...

Keyword(s):

Biceps Tendon ◽

Full Range ◽

Elbow Flexion ◽

Biceps Tenodesis ◽

Bicipital Groove ◽

Biceps Tenotomy ◽

Flexion Extension ◽

Before And After ◽

Long Head ◽

Scapular Motion

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Purpose/Hypothesis: To evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral intra-articular tenodesis. The hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after tenodesis. Study Design: Controlled laboratory study. Methods: Six fresh-frozen cadaveric arms were dissected to expose the long head of the biceps tendon as well as the bicipital groove. Inclinometers and fiducials (optical markers) were used to measure the motions of the scapula, forearm, and biceps tendon through a full range of shoulder and elbow motions. A suprapectoral biceps tenodesis was then performed, and the motions were repeated. The motion of the biceps tendon was quantified as a function of scapular or forearm motion in each plane, both before and after the tenodesis. Results: There was minimal motion of the native biceps tendon during elbow flexion and extension but significant motion during all planes of scapular motion before tenodesis, with the most motion occurring during shoulder flexion-extension (20.73 ± 8.21 mm). The motion of the biceps tendon after tenodesis was significantly reduced during every plane of scapular motion compared with the native state ( P < .01 in all planes of motion), with a maximum motion of only 1.57 mm. Conclusion: There was a statistically significant reduction in motion of the biceps tendon in all planes of scapular motion after the intra-articular biceps tenodesis. The motion of the biceps tendon within the bicipital groove was essentially eliminated after the suprapectoral biceps tenodesis. Clinical Relevance: This arthroscopic suprapectoral tenodesis technique can significantly reduce motion of the biceps tendon within the groove in this cadaveric study, possibly reducing the likelihood of groove pain in the clinical setting.

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Arthroscopic partial Superior Capsular Reconstruction using the Long Head of the Biceps Tendon–Technique Description

Arthroscopy Techniques ◽

10.1016/j.eats.2020.10.056 ◽

2021 ◽

Author(s):

Bernardo Barcellos Terra ◽

Tannous Jorge Sassine ◽

Benno Ejnisman ◽

Alberto de Castro Pochini ◽

Paulo Santoro Belangero

Keyword(s):

Biceps Tendon ◽

Superior Capsular Reconstruction ◽

Long Head

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Ultrasonographic Evaluation of the Shoulders and Its Associations with Shoulder Pain, Age, and Swim Training in Masters Swimmers

Medicina ◽

10.3390/medicina57010029 ◽

2020 ◽

Vol 57 (1) ◽

pp. 29

Author(s):

Yuta Suzuki ◽

Noriaki Maeda ◽

Junpei Sasadai ◽

Kazuki Kaneda ◽

Taizan Shirakawa ◽

...

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Structural Changes ◽

Partial Tear ◽

Increased Risk ◽

High Prevalence ◽

History Of ◽

Long Head ◽

Competitive Swimmers ◽

Rotator Cuff Tendinopathy

Background and objectives: The long head of the biceps (LHB) and rotator cuff tendinopathy is the major cause of shoulder pain in competitive swimmers. The risk of tendinopathy increases with aging; however, the structural changes of LHB and rotator cuff in populations of masters swimmers have not been well examined. The purpose of this study was to investigate the prevalence of ultrasonographic abnormalities of the shoulders in masters swimmers, and the association of pain, age, and swim training with structural changes in this population. Materials and Methods: A total of 60 subjects participated in this study, with 20 masters swimmers with shoulder pain, 20 asymptomatic masters swimmers, and 20 sex- and age-matched controls. All swimmers completed a self-reported questionnaire for shoulder pain, their history of competition, and training volume. Each subject underwent ultrasonographic examination of both shoulders for pathologic findings in the LHB tendon, rotator cuff (supraspinatus (SSP) and subscapularis (SSC)) tendons, and subacromial bursa (SAB) of both shoulders and had thickness measured. Results: The prevalence of tendinosis (LHB, 48.8%; SSP, 17.5%; SSC, 15.9%), partial tear (SSP, 35.0%), and calcification (SSC, 10.0%) were higher in swimmers than in controls. LHB and SSP tendinosis were associated with shoulder pain. Older age and later start of competition were associated with an increased risk of LHB tendinosis and SSC calcification. Earlier initiation of swimming and longer history of competition were associated with an increased risk of SSP and SSC tendinosis. The thicker SSP tendon significantly increased the risk of tendinosis and partial tear. Conclusions: A high prevalence of structural changes in the rotator cuff and biceps tendons in masters swimmers reflects the effect of shoulder symptoms, aging, and swim training.

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