Accuracy of preoperative MRI in the diagnosis of disorders of the long head of the biceps tendon

Malavolta, Eduardo Angeli; Assunção, Jorge Henrique; Guglielmetti, Cesar Luiz Betoni; Souza, Felipe Ferreira de; Gracitelli, Mauro Emílio Conforto; Neto, Arnaldo Amado Ferreira

doi:10.1016/j.ejrad.2015.07.031

Cited by 28 publications

(23 citation statements)

References 32 publications

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“…Em contrapartida, Malavolta et al 23 apresentaram em seu estudo uma sensibilidade moderada (67%) e uma alta especificidade (98%) para o exame de ressonância magnética. No referido estudo, foram avaliadas somente as rupturas totais do tendão da CLB, ao passo que em nosso estudo consideramos também sinais inflamatórios e as lesões parciais, o que poderia explicar a maior incidência de exames positivos.…”

Section: Discussionunclassified

Lesão do tendão do músculo supraespinal e sua relação com a lesão do tendão da cabeça longa do bíceps

Carvalho

Cohen

Belangero

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Identificar a correlação clínica, radiológica, e artroscópica das lesões do tendão da cabeça longa do bíceps e sua influência na dor do paciente quando associada às lesões do manguito rotador. Métodos Entre abril e dezembro de 2013, foram avaliados 50 pacientes, sendo 38 (76%) do sexo feminino e 12 (24%) do sexo masculino, com idade média de 65,1 anos. Os pacientes foram operados pelo Grupo de Ombro e Cotovelo da Disciplina de Medicina Esportiva do Departamento de Ortopedia e Traumatologia da Universidade Federal de São Paulo. Os indivíduos foram submetidos a reparo da lesão do manguito rotador com evidência clínica, radiológica e/ou artroscópica de acometimento do tendão da cabeça longa do bíceps. Resultados Observou-se associação entre dor à palpação do sulco intertubercular do úmero com lesão parcial de alto grau (ruptura parcial acometendo mais de 50% do tendão) na artroscopia (p = 0,003). Encontramos ainda uma associação entre a lesão de alto grau da cabeça longa do bíceps e a lesão do tendão do músculo supraespinal (p < 0,05), sendo que, para cada centímetro de lesão do tendão do músculo supraespinal, o paciente apresenta probabilidade 1,7 maior de ter uma lesão de alto grau da cabeça longa do bíceps. Conclusão A dor na região anterior do ombro à palpação do sulco intertubercular do úmero pode estar relacionada às lesões de alto grau da cabeça longa do bíceps. A lesão do manguito rotador e o seu tamanho são fatores de risco para lesão de alto grau do tendão da cabeça longa do bíceps.

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Section: Discussionunclassified

Lesão do tendão do músculo supraespinal e sua relação com a lesão do tendão da cabeça longa do bíceps

Carvalho

Cohen

Belangero

et al. 2020

Rev Bras Ortop (Sao Paulo)

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“…2,8 Despite recent advancement in imaging diagnosis of LHBT pathologies and rotator cuff lesions, arthroscopic techniques are still the main approach to confirm or detect hidden lesions that support diagnosis of LHBT instability and BRP tear. [9][10][11] reported that ASI pathogenesis leads to anterior shoulder pain during internal rotation, flexion, and adduction of the arm; 3 those authors highlighted that early detection of lesions in the pulley system and LHBT instability is key to avoid ASI progression. 3 Currently, no diagnostic standards are available for disorder of the pulley structure or LHBT instability.…”

Section: Discussionmentioning

confidence: 99%

Biceps tendon instability with or without pulley tears: an arthroscopic diagnostic study

Kao

Chiu

Hsu

et al. 2020

Preprint

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Background To investigate long head of the biceps tendon (LHBT) instability and biceps reflection pulley (BRP) lesions with dynamic arthroscopy in patients with refractory anterior shoulder pain and determine associated intraarticular pathologies. Methods Patients with refractory anterior shoulder pain and arthroscopically-diagnosed LHBT instability were enrolled. LHBT instability was confirmed by either static dislodge from the groove or subluxation induced by the hook probe (ramp test), and the integrity of BRP and concomitant intra-articular lesions were investigated. Demographics and arthroscopic findings were compared between patients with and without BRP tear. Results A total of 40 patients with refractory anterior shoulder pain and arthroscopically-diagnosed LHBT instability identified through review of medical records at a single surgeon’s practice from 2014 to 2017 were enrolled. BRP tear was noted in 25 patients (group A) and superior glenohumeral ligament (SGHL) insufficiency through ramp test, in 15 patients (group B). No significant difference of patient characteristics was observed between the two groups. Concomitant intraarticular pathologies were noted in 27 patients, including 19 in group A (76%) and eight in group B (53%), without significant group-wise difference (P = 0.083). The incidence of articular-side subscapularis tear was significantly higher in group A (P = 0.021), and those of the other intraarticular pathologies were similar between groups A and B. Fraying at the articular side of the subscapularis and supraspinatus tendons was frequent in group B, without difference of incidence as compared to group A (P = 0.5 and P = 0.084, respectively). Conclusions LHBT instability was a common disorder in patients with refractory shoulder pain. In patients with refractory anterior shoulder pain, dynamic assessment of BRP lesions and SGHL insufficiency and meticulous survey of associated intra-articular pathologies, including subscapularis tear are necessary for making accurate diagnosis.

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“…The bottom line is that the absence of pathologic findings on MRI is not sufficient enough to exclude biceps tendon pathology. 5…”

Section: Imaging Techniquesmentioning

confidence: 99%

Malpractice Counsel: Don’t Miss Popeye

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2017

Emerg Med

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Accuracy of preoperative MRI in the diagnosis of disorders of the long head of the biceps tendon

Cited by 28 publications

References 32 publications

Lesão do tendão do músculo supraespinal e sua relação com a lesão do tendão da cabeça longa do bíceps

Lesão do tendão do músculo supraespinal e sua relação com a lesão do tendão da cabeça longa do bíceps

Biceps tendon instability with or without pulley tears: an arthroscopic diagnostic study

Malpractice Counsel: Don’t Miss Popeye

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