We demonstrate the US appearance of the distal biceps tendon bifurcation in normal cadavers and volunteers and in those affected by various disease processes. Three cadaveric specimens, 30 normal volunteers, and 75 patients were evaluated by means of US. Correlative MR imaging was obtained in normal volunteers and patients. In all cases US demonstrated the distal biceps tendon shaped by two separate tendons belonging to the short and long head of the biceps brachii muscle. Four patients had a complete rupture of the distal insertion of the biceps with retraction of the muscle belly. Four patients had partial tear of the distal biceps tendon with different US appearance. In two patients the partial tear involved the short head of the biceps brachii tendon, while in the other two patients, the long head was involved. Correlative MR imaging is also presented both in normal volunteers and patients. US changed the therapeutic management in the patients with partial tears involving the LH of the biceps. This is the first report in which ultrasound considers the distal biceps tendon bifurcation in detail. Isolated tears of one of these components can be identified by US. Knowledge of the distal biceps tendon bifurcation ultrasonographic anatomy and pathology has important diagnostic and therapeutic implications.

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In nonprofessional tennis players with wrist injuries, different grips of the racket are related to the anatomical site of the lesion: Eastern grip with radial-side injuries and Western or semi-Western with ulnar-side injuries. Knowledge of this relationship may influence training, prevention, diagnosis, and therapy of wrist problems in nonprofessional tennis players.

US is promising for evaluating traumatic injuries of the MCN. By providing unique information on the entire course of the nerve, US can be used as a valuable complement of clinical and electrophysiologic findings.

Several accessory muscles in the upper and lower limb have been described in the medical literature. Most are asymptomatic and represent incidental findings at imaging. In some instances, however, these muscles may become clinically relevant producing palpable swelling, entrapment of neurovascular structures, or exercise-related pain. The diagnosis of accessory muscles is based on recognition of their typical location and on cross-sectional imaging features. Familiarity with their most common location and knowledge of the possible clinical syndromes caused by these supernumerary structures may aid in diagnosis and treatment.