Biceps Tendinitis

Finally, the synovial sheath of the long head of the biceps tendon is formed by an extrusion of the articular synovial membrane. As the sheath is merely an extension of the joint cavity, intra-articular effusion can lead to fluid in the sheath (see Fig. 6.23). Fluid secondary to an isolated biceps tendinitis is rare. 

Patten RM, Mack LA, Wang KY et al (1992) Nondisplaced fractures of the greater tuberosity of the humerus sonographic detection. Radiology 182 201-204 Patton WC, McCluskey III (2001) Biceps tendinitis and subluxation. Clin Sports Med 20 505-529 Peetrons P, Rasmussen OS, Creteur V et al (2001) Ultrasound of the shoulder joint non rotator cuff lesions. Eur J Ultrasound 14 11-19... 

Fig. 6.103a,b. Calcifying tendinitis of the pectoralis major tendon, a Anteroposterior radiograph shows a juxtacortical calcification (arrow) adjacent to the anterior proximal humeral shaft cortex, b Corresponding transverse 12-5 MHz US image over the myotendinous junction of the long head of the biceps (B) demonstrates a well-defined type I deposit (arrow) within the distal pectoralis major tendon (arrowheads). Hs, humeral shaft... 

The less common tendinitis and partial tears of the distal biceps tendon present with localized pain and tenderness over the antecubital fossa. These conditions usually follow repetitive microtrauma or forceful biceps activation. Pain can be exacerbated during resisted elbow flexion or supination of the hand and is worsened by direct palpation of the tendon. At US, partial tears appear as hypoechoic thickening or thinning of the tendon and as contour... 

Next, every effort should be made to localize the pain as precisely as possible because this can provide useful information to target the US examination. As a general rule, diffuse knee pain derives from joint lesions, whereas more localized pain is more commonly related to tendon involvement and local disorders. Information on the character, duration and location of pain is extremely helpful in the evaluation of tendinitis. In jumper s knee , for instance, the patient typically reports pain over the most proximal portion of the patellar tendon, just behind the tip of the patella. Runners complaining of lateral knee pain and tenderness should be questioned for signs of tendinitis affecting the distal insertion of the biceps femoris and the iliotibial band, so-called runner s knee . In the event of soft-tissue lumps or indeterminate swelling around the... 

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