Ultrasound assessment in distal biceps tendon injuries: Techniques, pearls and pitfalls

Al-Ani, Zeid; Lauder, Joshua

doi:10.1016/j.clinimag.2021.01.017

Cited by 8 publications

(10 citation statements)

References 23 publications

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“…The tendon can be assessed in the longitudinal and transverse planes with elbow extension and forearm supination, to bring the posteriorly positioned radial tuberosity into a more medial position (Figure 4). 22 A partial tear will result in hypoechoic changes and tendon attenuation but no complete disruption, while a complete tear will result in full tendon discontinuity. However, ultrasound assessment of the distal biceps tendon using anterior approach only can be challenging, as the distal biceps tendon has a deep course towards its attachment, often resulting in significant anisotropy artefact (Figure 4).…”

Section: Distal Biceps Tendon Injurymentioning

confidence: 99%

“…This can be performed using a medial or lateral approach. 22 The lateral approach in particular is optimal for assessing the distal biceps tendon dynamically. 22 In this technique, the patient is sat on a chair facing the examiner and the elbow is rested on the examination table in 90° flexion.…”

Section: Distal Biceps Tendon Injurymentioning

confidence: 99%

“…22 The lateral approach in particular is optimal for assessing the distal biceps tendon dynamically. 22 In this technique, the patient is sat on a chair facing the examiner and the elbow is rested on the examination table in 90° flexion. The transducer is placed transversely in relation to the proximal radius to identify the characteristic appearances of the supinator muscle wrapping around the radial neck, deep to the extensor muscles.…”

Section: Distal Biceps Tendon Injurymentioning

confidence: 99%

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Role of dynamic ultrasound in assessment of the snapping elbow and distal biceps tendon injury

2021

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Introduction Ultrasound is useful in assessing patients with snapping syndromes around the elbow joint. The dynamic nature of the examination allows for direct visualisation of the underlying causative factor. Topic description: We discuss the role of dynamic ultrasound in assessing various snapping syndromes around the elbow, such as ulnar nerve instability, snapping triceps and less commonly, snapping brachialis. Ultrasound is also useful in evaluating the distal biceps tendon, particularly in differentiating partial from complete tendon injury. Discussion Ulnar nerve instability and snapping triceps can be assessed via a medial approach with the transducer placed transversely between the medial epicondyle and the olecranon. In ulnar nerve instability, the nerve can be seen crossing over the medial epicondyle on elbow flexion. In snapping triceps syndrome, both the ulnar nerve and the distal triceps can be seen dislocating over the medial epicondyle. Dynamic assessment of the distal biceps tendon using a lateral approach minimises anisotropy artefact often seen on the anterior approach. Passive pronation and supination of the forearm will reveal little or no movement in a completely torn tendon whereas moving tendon fibres will be appreciated in partial tears. In a snapping brachialis, the medial portion of brachialis will be seen abnormally translocating anterolateral to the medial border of the trochlea during elbow flexion and snapping back into its normal position on elbow extension. Conclusion Dynamic ultrasound of the elbow is valuable in diagnosing patients with snapping sensations around the joint and in evaluating the integrity of the distal biceps tendon.

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Section: Distal Biceps Tendon Injurymentioning

confidence: 99%

Section: Distal Biceps Tendon Injurymentioning

confidence: 99%

Section: Distal Biceps Tendon Injurymentioning

confidence: 99%

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Role of dynamic ultrasound in assessment of the snapping elbow and distal biceps tendon injury

2021

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“…position" to access the tendon footprint avoiding the vulnerable adjacent neurovascular structures (Figure 10c) [79]. Potentially vulnerable structures when injecting the DBT are the brachial artery and median nerve, which follow the LF.…”

Section: Us Scanning and Guided Injectionmentioning

confidence: 99%

“…Barker et al [78] concluded on a cohort of six patients that a US-guided PRP injection was an effective (regarding improving pain and performance scores) and a safe procedure, but further investigation involving RCT is needed. For the DBT injection, the patient can be positioned supine with the forearm in the "cobra position" to access the tendon footprint avoiding the vulnerable adjacent neurovascular structures (Figure 10c) [79]. Potentially vulnerable structures when injecting the DBT are the brachial artery and median nerve, which follow the LF.…”

Section: Us Scanning and Guided Injectionmentioning

confidence: 99%

Ultrasound-Guided Procedures in Common Tendinopathies at the Elbow: From Image to Needle

et al. 2021

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Elbow pain is a prevalent condition in musculoskeletal physicians’ settings. The majority of cases present with periarticular pathologies (varying from tendinopathy to nerve entrapment syndrome). Nevertheless, in some cases, the underlying cause can be intra-articular, e.g., loose bodies or rheumatic disease. Progress in ultrasound (US) technology has yielded high-resolution assessment of the elbow and, importantly, allows real-time, radiation-free guidance for interventions. Particularly in ambiguous cases, US imaging is necessary to arrive at the correct diagnosis. The following four clinical conditions are covered: tennis elbow, golfer’s elbow, distal biceps, and distal triceps tendinopathy. The present review illustrates cadaveric elbow anatomy, corresponding US images, and exemplary pathologies. Additionally, the authors also discuss the existing evidence on ultrasound-guided procedures in the conditions mentioned above.

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Acute and Chronic Elbow Disorders

Daniels

Fritz

2023

Magnetic Resonance Imaging Clinics of North America

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Ultrasound assessment in distal biceps tendon injuries: Techniques, pearls and pitfalls

Cited by 8 publications

References 23 publications

Role of dynamic ultrasound in assessment of the snapping elbow and distal biceps tendon injury

Role of dynamic ultrasound in assessment of the snapping elbow and distal biceps tendon injury

Ultrasound-Guided Procedures in Common Tendinopathies at the Elbow: From Image to Needle

Acute and Chronic Elbow Disorders

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