Can Quantification of Biceps Peritendinous Effusion Predict Rotator Cuff Pathologies?

Abstract

Sonographically detected BPE seems to be in association with certain rotator cuff pathologies, and it can be utilized as an adjuvant finding to rule out such rotator cuff abnormalities.

Association of Bicipital Peritendinous Effusion with Subacromial Impingement: A Dynamic Ultrasonographic Study of 337 Shoulders

“…The supraspinatus tendon and subscapularis bursa were scanned by placing the arm behind the back to shift the tendon away from the coverage of the acromion. The hand was put on the contralateral shoulder during the examination of the infraspinatus tendon and the posterior shoulder recess891013. Regarding the dynamic subdeltoid imaging test; the arm was rested beside the trunk with the transducer placed lateral to the acromion along the scapular axis.…”

“…Subluxation of the biceps tendon was diagnosed if part of the tendon was displaced from the bicipital groove, whereas dislocation was diagnosed if the whole tendon was outside the groove. A full-thickness tear of the rotator cuff tendons was defined as an intra-tendinous gap extending from the bursal to the articular aspect, while a partial thickness tear was defined as a gap on either side or inside the tendon89101315. One antecedent study indicated that simultaneous presentation of BPE with subdeltoid bursa effusion usually coexisted with rotator cuff tendon tears16.…”

“…The short axis view of the biceps tendon (with light touch of the probe) was used for measurement of the BPE, which was visualized as an anechoic compressible fluid collection surrounding the LHBT891013. A point on the border of the biceps tendon with the greatest effusion thickness was determined visually.…”

“…Since the subscapularis tendon and subdeltoid bursa have no direct connection with the glenohumeral joint, concomitant presence of BPE and subdeltoid bursitis or subscapularis tendinopathy may all result from the same pathological mechanism, namely subacromial impingement. Although the relationship between BPE and static sonographic images of shoulder joints was established in previous research8910, its association with dynamic US examination has never been clarified. Therefore, the present study was designed to explore the association of the development of BPE with the US dynamic subacromial impingement test.…”

“…Bicipital peritendinous effusion (BPE) is commonplace during shoulder US evaluation and is attributed to intra-articular pathology because the bicipital tendon sheath derives from the extension of the glenohumeral joint capsule67. Several recent ultrasonographic studies have demonstrated independent associations of BPE with subscapularis tendinopathy and subdeltoid bursitis8910. Since the subscapularis tendon and subdeltoid bursa have no direct connection with the glenohumeral joint, concomitant presence of BPE and subdeltoid bursitis or subscapularis tendinopathy may all result from the same pathological mechanism, namely subacromial impingement.…”