Ultrasound appearance and dynamic evaluation of variant long head of the biceps tendon anatomy with MRI correlation

Abstract

Many variants of the long head of the biceps tendon exist but their appearance has not been documented with ultrasonography (US). We describe a case of variant LHB anatomy that was visualized by magnetic resonance imaging and confirmed with US. Additionally, US was useful to exclude instability of the LHBT. To the best of our knowledge, this variant appearance of the LHBT has not been previously described with US. Considering that shoulder US is routinely performed clinically, knowledge of the appearance of variant LHBT anatomy may be useful.Riassunto Esistono molte varianti del tendine del capo lungo del bicipite, ma il loro aspetto non è stato documentato con ecografia (US). Descriviamo un caso di variante anatomica del LHBT visualizzata con risonanza magnetica e confermata con gli US. Inoltre, gli US sono stati utili per escludere l'instabilità del LHBT. Per quanto a nostra conoscenza, questa variante del LHBT non è stata descritta in precedenza con gli US. Considerando che l'ecografia della spalla viene eseguita di routine nella pratica clinica, la conoscenza della variante anatomica del LHBT può essere utile.

Imaging of Anatomical Variants of the Long Head Biceps Tendon

“…Rarely, three tendon-like structures are seen on MRI and US. 44 In our case, we observed two tendons with a single intra-articular origin from the supraglenoid tubercle and one with an extraarticular origin from the supraspinatus (►Fig. 14 a, b).…”

Uncommon Bilateral Absence of Long Heads of the Biceps Tendons in Twin Sisters

“…There are reports of LHBT aponeurotic expansion or of being incorporated into the superior capsule, with visualization of a mesotenon 11 . A small number of reports of multiple heads of biceps brachii are also available [12][13][14] .…”

Muskelverletzungen des Sportlers

“…Die Sonographie hat aufgrund ihrer hohen Sensitivität insbesondere in der Evaluierung von Läsionen der distalen Bizepssehne einen großen Stellenwert [39,43]. Aufgrund der unterschiedlichen Einschallmöglich-keiten können anisotropiebedingte Artefakte ausgeschlossen werden [44], eine Totalruptur des an der Tuberositas radii inserierenden Anteils kann bei noch intaktem Lacertus fibrosus und daher fehlender Sehnenretraktion verlässlich diagnostiziert werden [45]. Zudem können mithilfe der dynamischen Untersuchung Teilläsionen von Komplettrupturen mit dazwischen gelegenem Hämatom sicher unterschieden werden [46].…”