Variations of the intra-articular portion of the long head of the biceps tendon: A classification of embryologically explained variations

Dierickx, Carl; Ceccarelli, E.; Conti, Marco; Vanlommel, Jan; Castagna, Alessandro

doi:10.1016/j.jse.2009.03.006

Cited by 76 publications

(71 citation statements)

References 21 publications

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“…Variant intra-and extra-articular anatomy of the LHBT is well described in the literature. In one study variant intra-articular LHBT anatomy was present in 1.91 % of a retrospective review of 2,976 shoulder arthroscopies [1]. A separate review of 671 shoulder arthroscopies showed a higher prevalence of intra-articular LHBT variant anatomy of 7.4 % [2].…”

Section: Discussionmentioning

confidence: 95%

“…A separate review of 671 shoulder arthroscopies showed a higher prevalence of intra-articular LHBT variant anatomy of 7.4 % [2]. Classification systems for variant intra-articular LHBT anatomy have been proposed [1]. Another cadaveric study using MRI described the origin of an accessory biceps head from the intertubercular sulcus with incorporation distally into the biceps muscle belly [3].…”

Section: Discussionmentioning

confidence: 99%

“…The LHBT may also originate from the rotator cuff, have an extra-articular origin, or be congenitally absent [4][5][6]. Clinically, there is an association between variant intraarticular LHBT anatomy and other shoulder pathologies, especially labral tears [1,2]. US has been shown to be both sensitive and specific in the detection of LHBT full thickness tears and subluxation and dislocation [7].…”

Section: Discussionmentioning

confidence: 99%

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

2014

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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.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

2014

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“…Anatomic variations in the origins of the long head of the biceps brachii are rare. Dierickx et al 3) have shown only 1.91%…”

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confidence: 94%

“…Broadly, anatomic variations is classified into whether they have anomalous origins or there is a congenital absence of the long head itself. 3,4) Most of these variations are only revealed coincidently during arthroscopic surgery, and the clinical significance of these anatomic variants remain unclear. Although there have been reports that congenital absence of the long head of biceps brachii contributes to the instability of the shoulder or to related congenital defects, 5) there is no conclusive evidence as of yet to implicate these anatomic variations to shoulder pathology.…”

mentioning

confidence: 99%

Three Cases of Rare Anatomic Variations of the Long Head of Biceps Brachii

Kwak

Lee

Song³

et al. 2015

Clinics in Shoulder and Elbow

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In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations. In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle. From its origin, the long head traverses along the rotator interval and the humeral head and extends into the bicipital groove. 1)Cadaver studies by Vangsness et al.2) have shown that around 50% of long heads of the biceps brachii originate from the superior labrum while the rest arises from the supraglenoid tubercle. It is reported that most tendinous fibers of the long head of the biceps brachii merge with the labrum at the posterior superior labrum. Anatomic variations in the origins of the long head of the biceps brachii are rare. Dierickx et al.3) have shown only 1.91%of patients undergoing arthroscopic surgery show such anomaly. Broadly, anatomic variations is classified into whether they have anomalous origins or there is a congenital absence of the long head itself. 3,4) Most of these variations are only revealed coincidently during arthroscopic surgery, and the clinical significance of these anatomic variants remain unclear. Although there have been reports that congenital absence of the long head of biceps brachii contributes to the instability of the shoulder or to related congenital defects, 5) there is no conclusive evidence as of yet to implicate these anatomic variations to shoulder pathology.Until now, only a single case of an anatomic variation of the origin of the long head other than congenital absence has been reported in the Korean literature.6) In this report, we describe 3 cases of anatomic variations of the long head of the biceps brachii found during arthroscopic repairs of supraspinatus tendon tears. Case Report Case 1A 40-year-old female was hospitalized with chronic pain on the right shoulder that began 3 weeks prior to the observation. The patient had no job sequence and no exercise routines other than static yoga poses that she performed. The patient showed no obvious signs of trauma, but experienced severe pain with forward elevation of the arm and night pain. She had a visual analogue scale (VAS) for pain of 5. During physical examination, the patient presented with limited passive range of motion (ROM) of the shoulders; 150 o of forward elevation and 150 o of abduction of the arm. Further, the patient showed signs of impingement, a positive outcome for the empty can test, and tenderness at the supraspinatus attachme...

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