Sonography of the bicipitoradial bursa

Abstract

KEYWORDSBicipitoradial bursa; Distal tendon of the biceps brachii; Ultrasonography.Abstract Serous bursae consist of a synovial membrane enveloping a film of liquid. They are located at interfaces between moving structures where friction must be reduced. The bicipitoradial bursa lies between the distal tendon of the biceps brachii, which it surrounds, and the radial tuberosity. It is a relatively large bursa, with dimensions ranging from 2.4 to 3.9 cm. It sometimes presents septation. It does not communicate with the joint cavity, but it may communicate with the interosseous bursa of the elbow. Regardless of its cause, bicipitoradial bursitis presents as a mass in the cubital fossa and/or with neurological symptoms (sensorial and/or motorial) caused by compression of the radial nerve. On ultrasonography, the inflamed bursa is visualized as an anechoic formation surrounding the distal biceps tendon. In addition to its role in diagnosing the bursitis, sonography can provide information about radial nerve injury (in the presence of macroscopic damage), and it can also be used for guidance during intrabursal injections.Sommario Le borse sierose sono costituite da membrana sinoviale che circonda un film liquido; sono localizzate dove è necessario ridurre la frizione tra strutture in movimento.La borsa bicipito-radiale è posta tra il tendine distale del bicipite, che avvolge, ed il tubercolo radiale. È una borsa discretamente voluminosa, che può raggiungere dimensioni tra 2,4 e 3,9 cm.Può essere settata, non comunica con la cavità articolare, può comunicare con la borsa interossea.Indipendentemente dall'eziologia, la borsite si presenta come massa a livello della fossa cubitale, o con sintomi sensitivi e/o motori legati alla compressione del nervo radiale, o in entrambi i modi.Ecograficamente si presenta come formazione anecogena, che circonda il tendine distale del bicipite. Oltre alla diagnosi di borsite, l'ecografia consente di valutare la sofferenza del nervo radiale, quando sono presenti danni macroscopici, e infiltrazioni guidate della borsa. ª

Elbow nerves: normal sonographic anatomy and identification of the structures potentially associated with nerve compression. A short pictorial-video article

“…Ultrasonography is a reliable method for the evaluation of the nerves of the elbow [1][2][3] and of the structures that may cause its compression [4][5][6][7][8].…”

“…The superficial radial nerve may be subject to chronic compression by bicipitoradial bursa [7] (Fig. 4).…”

Distal Biceps Brachii Tendon Insertion

“…Between the bone and the tendon, right before the distal attachments, there is a bursa that reduces frictional stresses over the tendon, avoiding microtraumas, especially during pronosupinantion 6,7 . Since it lies between the radial tuberosity posteriorly and the tendon, which is anterior, the so‐called bicipitoradial bursa is a fairly large bursa.…”

Ultrasound classification of traumatic distal biceps brachii tendon injuries

“…Both components are surrounded by a single paratenon [ 9 ], which can contain peritendinous fluid or effusion surrounding the whole tendon in acute traumatic injuries such as partial tears [ 10 ]. The latter must be differentiated from bicipitoradial bursal effusion, found between DBBT and the radial tuberosity, with occasional communications to the interosseous bursae [ 11 ]. Besides the DBBT, the biceps brachii muscle also attaches distally by means of the bicipital aponeurosis, also known as the lacertus fibrosus , which is a complex fibrous structure that arises medial to the DBBT at the myotendinous junction of the biceps brachii muscle and it runs medial to merge with the antebrachial fascia [ 5 ].…”