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Distal Biceps Tendinopathy

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1. Radiologic and Histologic Evaluation of Proximal Bicep Pathology in Patients With Chronic Biceps Tendinopathy Undergoing Open Subpectoral Biceps Tenodesis. (PubMed)

Radiologic and Histologic Evaluation of Proximal Bicep Pathology in Patients With Chronic Biceps Tendinopathy Undergoing Open Subpectoral Biceps Tenodesis. To correlate preoperative magnetic resonance imaging (MRI) and intraoperative anatomic findings within the proximal long head biceps tendon to histologic evaluation of 3 separate zones of the tendon in patients with chronic biceps tendinopathy.Sixteen patients with chronic biceps tendinopathy were treated with open subpectoral biceps (...) (7.3 ± 1.5) compared with zone 3 (5.0 ± 1.1). Cell morphology scores in zone 1 (1.9 ± 0.4) and zone 2 (1.5 ± 0.6) were significantly higher than that in zone 3 (0.8 ± 0.3) (P < .05). Inflammatory tenosynovium showed weak correlation with tendon changes in zone 1 (r = 0.08), zone 2 (r = 0.03), or zone 3 (r = 0.1).In patients with chronic long head biceps tendinopathy who underwent open subpectoral tenodesis, MRI and intraoperative assessment did not show significant structural abnormalities within

2018 Arthroscopy

2. Distal Biceps Tendinopathy

Distal Biceps Tendinopathy Distal Biceps Tendinopathy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Distal Biceps Tendinopathy (...) Distal Biceps Tendinopathy Aka: Distal Biceps Tendinopathy , Distal Biceps Tendon Rupture , Biceps Tendonitis at the Elbow From Related Chapters II. History Repetitive motion injury Repeated elbow flexion AND Supination or pronation III. Symptoms Vague, anterior developing gradually with overuse IV. Signs: Distal Biceps Tendinopathy Anterior (in antecubital fossa) exacerbating factors flexion against resistance supination against resistance V. Signs: Distal Biceps Tendon Rupture Distal biceps tendon

2018 FP Notebook

3. Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy. (PubMed)

Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy. To assess the efficacy and safety of radial extracorporeal shock wave therapy (rESWT) for chronic distal biceps tendinopathy (cDBT).Case-control study (level of evidence, 3).SUN Orthopaedics and Sports Medicine.Patients with a diagnosis of cDBT were recruited between January 2010 and February 2015.Patients received a single session of rESWT (2000 shock waves with energy flux density of 0.18 mJ

2016 Clinical Journal of Sport Medicine

4. Ultrasound classification of traumatic distal biceps brachii tendon injuries (Full text)

Ultrasound classification of traumatic distal biceps brachii tendon injuries The present work is aimed at analysing ultrasound findings in patients with distal biceps brachii tendon (DBBT) injuries to assess the sensitivity of ultrasound in detecting the different forms of injury, and to compare ultrasound results with magnetic resonance imaging (MRI) and surgical results.A total of 120 patients with traumatic DBBT injuries examined between 2011 and 2015 were analysed. We compared ultrasound (...) fibres remain intact (tendinopathies, elongations and low-grade partial tears), are the most difficult to interpret, as ultrasound and MRI reports disagreed in 12 out of 39 cases and no surgical confirmation could be obtained.Based on present results and previous MRI classifications, we establish a traumatic DBBT injury ultrasound classification. The sensitivity and ultrasound-surgery correlation results in the diagnosis of major DBBT injuries obtained in the present study support the recommendation

2017 Skeletal radiology PubMed

5. Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies (Full text)

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies In the second part of this review article the management of medial elbow tendinopathy, distal biceps and distal triceps tendinopathy will be discussed. There is a scarcity of publications concerning any of these tendinopathies. This review will summarise the current best available evidence in their management. Medial elbow tendinopathy, also known as Golfer's elbow, is up to 6 times less common than (...) and topical NSAIDs. Injection therapy and surgical excision are utilised for recalcitrant cases. Distal biceps and triceps tendinopathies are very rare and there is limited evidence published. Sequelae of tendinopathy include tendon rupture and so it is vital to manage these tendinopathies appropriately in order to minimise this significant complication. Their management and that of partial tears will be considered.

2013 Shoulder … Elbow PubMed

6. Distal Biceps Tendinopathy

Distal Biceps Tendinopathy Distal Biceps Tendinopathy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Distal Biceps Tendinopathy (...) Distal Biceps Tendinopathy Aka: Distal Biceps Tendinopathy , Distal Biceps Tendon Rupture , Biceps Tendonitis at the Elbow From Related Chapters II. History Repetitive motion injury Repeated elbow flexion AND Supination or pronation III. Symptoms Vague, anterior developing gradually with overuse IV. Signs: Distal Biceps Tendinopathy Anterior (in antecubital fossa) exacerbating factors flexion against resistance supination against resistance V. Signs: Distal Biceps Tendon Rupture Distal biceps tendon

2015 FP Notebook

7. Biceps Tendinopathy (Follow-up)

M, Familiari F, Castricini R. Tenotomy versus tenodesis in the treatment of the long head of biceps brachii tendon lesions. BMC Musculoskelet Disord . 2012 Oct 22. 13:205. . . Zhang J, Ebraheim N, Lause GE. Ultrasound-guided injection for the biceps brachii tendinitis: results and experience. Ultrasound Med Biol . 2011 May. 37(5):729-33. . Furia JP, Rompe JD, Maffulli N, Cacchio A, Schmitz C. Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy (...) Biceps Tendinopathy (Follow-up) Biceps Tendinopathy Follow-up: Deterrence, Complications, Prognosis Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzI3MjI3LWZvbGxvd3Vw processing > Biceps Tendinopathy Follow-up

2014 eMedicine.com

8. Biceps Tendinopathy (Diagnosis)

and experience. Ultrasound Med Biol . 2011 May. 37(5):729-33. . Furia JP, Rompe JD, Maffulli N, Cacchio A, Schmitz C. Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy. Clin J Sport Med . 2016 Nov 23. . Wober W, Rahlfs VW, Buchl N, et al. Comparative efficacy and safety of the non-steroidal anti-inflammatory drugs nimesulide and diclofenac in patients with acute subdeltoid bursitis and bicipital tendinitis. Int J Clin Pract . 1998 Apr-May. 52(3):169-75 (...) Biceps Tendinopathy (Diagnosis) Biceps Tendinopathy: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzI3MjI3LW92ZXJ2aWV3 processing > Biceps Tendinopathy Updated: Jul 20

2014 eMedicine.com

9. Biceps Tendinopathy (Treatment)

of the medication. [ ] Avoid direct injection into the biceps tendon. Myofascial trigger point injections in the scapular stabilizer muscles may be beneficial. This technique uses an injection with dilute local anesthetic. Manipulation may be helpful, especially for first-rib abnormalities that contribute to the syndrome. A study by Furia et al indicated that radial extracorporeal shock wave therapy (rESWT) is an effective treatment for chronic distal biceps tendinopathy. The mean visual analog scale scores (...) and experience. Ultrasound Med Biol . 2011 May. 37(5):729-33. . Furia JP, Rompe JD, Maffulli N, Cacchio A, Schmitz C. Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy. Clin J Sport Med . 2016 Nov 23. . Wober W, Rahlfs VW, Buchl N, et al. Comparative efficacy and safety of the non-steroidal anti-inflammatory drugs nimesulide and diclofenac in patients with acute subdeltoid bursitis and bicipital tendinitis. Int J Clin Pract . 1998 Apr-May. 52(3):169-75

2014 eMedicine.com

10. Biceps Tendinopathy (Overview)

and experience. Ultrasound Med Biol . 2011 May. 37(5):729-33. . Furia JP, Rompe JD, Maffulli N, Cacchio A, Schmitz C. Radial Extracorporeal Shock Wave Therapy Is Effective and Safe in Chronic Distal Biceps Tendinopathy. Clin J Sport Med . 2016 Nov 23. . Wober W, Rahlfs VW, Buchl N, et al. Comparative efficacy and safety of the non-steroidal anti-inflammatory drugs nimesulide and diclofenac in patients with acute subdeltoid bursitis and bicipital tendinitis. Int J Clin Pract . 1998 Apr-May. 52(3):169-75 (...) Biceps Tendinopathy (Overview) Biceps Tendinopathy: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzI3MjI3LW92ZXJ2aWV3 processing > Biceps Tendinopathy Updated: Jul 20

2014 eMedicine.com

11. Biceps Tendon Sheath Injection: An Anatomical Conundrum. (PubMed)

Biceps Tendon Sheath Injection: An Anatomical Conundrum. Long head biceps tendon peritendinous or sheath injections are routinely administered at or immediately distally to the bicipital groove. The main indication for injection remains the clinical diagnosis or treatment of biceps tendinopathy, although true inflammation of the tendon within the bicipital groove is rare. Because the tendon sheath is merely an extension of the joint cavity, it is plausible to assume that an injection (...) into the sheath would result in intraarticular spread. Surprisingly, such an anatomical tenet has a vague confirmation in the published clinical literature. This experiment was undertaken to investigate patterns of injectate spread when peri-tendon injection at the bicipital groove is performed.An experimental cadaveric study.An institutional clinical anatomy laboratory.Twelve ultrasound-guided methylene blue injections of the bicep tendon sheath were performed on cadaver specimens. Dissections and gross

2018 Pain Medicine

12. Lateral antebrachial cutaneous nerve compression after traumatic rupture of the long head of the biceps: a case series. (PubMed)

of the musculocutaneous nerve or LABC nerve. The biceps muscle and tendon had migrated distally toward the LABC nerve, demonstrating compression of the nerve.Proximal biceps tears commonly occur from trauma as well as iatrogenically after a biceps tenotomy for treatment of biceps tendinopathy. However, it is unusual for neuropathy of the LABC nerve to occur. Patients who develop neuropathy associated with the LABC nerve after a proximal biceps rupture can be effectively treated with LABC nerve decompression (...) Lateral antebrachial cutaneous nerve compression after traumatic rupture of the long head of the biceps: a case series. Lateral antebrachial cutaneous (LABC) nerve compression is a rare but debilitating injury. There are limited data on the association of LABC nerve compression and proximal biceps rupture. We theorized that because of distal migration, the biceps muscle and tendon cause compression on the nerve.We present 2 cases in which patients had proximal biceps ruptures with tendon

2014 Journal of Shoulder and Elbow Surgery

13. Anatomic and radiographic comparison of arthroscopic suprapectoral and open subpectoral biceps tenodesis sites. (PubMed)

Anatomic and radiographic comparison of arthroscopic suprapectoral and open subpectoral biceps tenodesis sites. Arthroscopic suprapectoral and open subpectoral surgical techniques are both commonly utilized approaches for proximal biceps tenodesis of the long head of the biceps brachii. A central limitation to the widespread use of an arthroscopic approach for biceps tenodesis is that the tendon may be tenodesed too proximally in the bicipital groove, leading to persistent pain and tendinopathy (...) ) software from the proximal lip of the humeral tunnel to regional landmarks.Both techniques were able to place the humeral tunnel distal to the bicipital groove in all specimens. On average, the open subpectoral approach placed the tunnel 2.2 cm distal to the arthroscopic suprapectoral approach.The arthroscopic suprapectoral biceps tenodesis technique used in this study consistently placed the tenodesis tunnel distal to the bicipital groove, which may allay concerns about the bicipital groove as a pain

2013 American Journal of Sports Medicine

14. Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures. (PubMed)

Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures. Lateral and medial epicondylitis are common causes of elbow pain in the general population, with the lateral variety being more common than the medial by a ratio reportedly ranging from 4:1 to 7:1. Initially thought to be an inflammatory condition, epicondylitis has ultimately been shown to result from tendinous microtearing followed by an incomplete reparative response. Numerous nonoperative and operative (...) treatment options have been employed in the treatment of epicondylitis, without the emergence of a single, consistent, universally accepted treatment protocol. Tendon ruptures about the elbow are much less frequent, but result in more significant disability and loss of function. Distal biceps tendon ruptures typically occur in middle-aged males as a result of an event that causes a sudden, eccentric contraction of the biceps. Triceps tendon ruptures are exceedingly rare but usually have a similar

2009 Journal of Hand Surgery - American

15. AIM Clinical Appropriateness Guidelines for Joint Surgery

Test ? Tenderness over the AC joint ? Imaging findings (x-ray or MRI) consistent with AC joint arthritis o Moderate to severe degenerative joint disease of the AC joint, distal clavicle edema, or osteolysis of the distal clavicle on MRI o Moderate to severe AC joint arthritis on x-ray ? Failure of at least twelve (12) weeks of conservative management Tendinopathy of the Long Head of the Biceps All of the following are required: ? Anterior shoulder pain, weakness ? Tenderness over the biceps groove (...) of the following tests: o O’Brien (active compression) o Anterior slide o Biceps load (I and II) o Pain provocation o Crank Test o Jobe relocation o Forced shoulder abduction and elbow flexion o Resisted supination – external rotation ? MRI demonstrating a traumatic non-anatomic SLAP lesion consistent with subjective and objective findings ? Failure of at least twelve (12) weeks of conservative management Copyright © 2019. AIM Specialty Health. All Rights Reserved. Joint Surgery 14 Subacromial Impingement

2019 AIM Specialty Health

17. Management of Rotator Cuff Injuries

Repair 7 Distal Clavicle Resection 8 Diagnosis (Clinical Examination) 8 Diagnosis (Imaging) 8 Post-op Mobilization Timing 8 Corticosteroid Injections for Rotator Cuff Tears 9 hyaluronic Acid Injections for Rotator Cuff Tears 9 Platelet Rich Plasma (PRP) Injection in Partial-Thickness Tears 9 High-grade Partial Thickness Rotator Cuff Tears 9 Prognostic Factors (Age) 10 Prognostic Factors (Higher BMI) 10 Prognostic Factors (Worker’s Compensation) 10 Prognostic Factors (Comorbidites) 10 Prognostic (...) of Small to Medium Tears 25 Long Term Non-Operative Management 26 Operative Management 27 Acromioplasty& Rotator Cuff Repair 28 Distal Clavicle Resection 29 Diagnosis (Clinical Examination) 30 Diagnosis (Imaging) 34 Post-op Mobilization Timing 36 Corticosteroid Injections for Rotator Cuff Tears 38 hyaluronic Acid Injections for Rotator Cuff Tears 39 Platelet Rich Plasma (PRP) Injection in Partial-Thickness Tears 40 High-grade Partial Thickness Rotator Cuff Tears 41 Prognostic factors (age) 42

2019 American Academy of Orthopaedic Surgeons

18. Exam Series: Guide to the Shoulder Exam

and mechanical symptoms with resistance that then resolves with supination is a positive test. A positive test indicates a SLAP tear (superior labral tear from anterior to posterior), which is often comorbid with bicep tendinopathy. Neurovascular exam : The neurovascular exam must be conducted before and after every reduction. Sensory function should be tested with both light touch and pinpoint. Nerve Origin Motor function Sensory function Reflexes Axillary C5,6 Deltoid: arm abduction Deltoid muscle (...) injury. Restrictive shoulder movement from capsular thickening and scarring progressing from a freezing to frozen to thawing phase. Muscular atrophy. Pain is often most severe at night and localized to the deltoid. Clinical diagnosis. Neurovascular exam is necessary to rule out nerve injury. Bicep Tendinopathy Acute or chronic tenditis (inflammation) or tendinosis (tears). May be associated with labrum tears. Pain with palpation in the anterior shoulder and along the biceps groove. Pain with forearm

2018 CandiEM

19. Shoulder Conditions Diagnosis and Treatment Guideline

Department of Labor and Industries Medical Treatment Guideline for Shoulder Diagnosis and Treatment –updated May 2018 D. Acromioclavicular dislocation 20 Diagnosis and treatment 20 Diagnosis and treatment 22 E. Acromioclavicular arthritis 23 Diagnosis and treatment 23 F. Glenohumeral dislocation 23 Diagnosis and treatment 23 G. Tendon rupture or tendinopathy of the long head of the biceps 24 H. Glenohumeral arthritis and arthropathy 25 I. Manipulation under anesthesia/arthroscopic capsular release 25 J (...) treatment for multi-directional instability that pre- dates injury. G. Tendon rupture or tendinopathy of the long head of the biceps Tendinopathy of the long head of the biceps most commonly presents in combination with rotator cuff tears, SLAP lesions, and bursitis. Washington State Department of Labor and Industries Medical Treatment Guideline for Shoulder Diagnosis and Treatment –updated May 2018 Diagnosis and treatment Patients typically present with increasing anterior shoulder pain, declining

2018 Washington State Department of Labor and Industries

20. AIM Clinical Appropriateness Guidelines for Joint Surgery

(12) weeks of conservative management Tendinopathy of the Long Head of the Biceps All of the following are required: ? Anterior shoulder pain, weakness ? Tenderness over the biceps groove ? Pain in the anterior shoulder during resisted supination of the forearm ? Positive Speed or Yeagerson Test ? MRI confirmation of biceps pathology Copyright © 2017. AIM Specialty Health. All Rights Reserved. Joint Surgery 16 Selected References 1. American Academy of Orthopaedic Surgeons, Optimizing (...) ; synovectomy, complete 29822 Arthroscopy, shoulder, surgical; debridement, limited 29823 Arthroscopy, shoulder, surgical; debridement, extensive 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface Mumford Procedure 23120 Claviculectomy; partial 23410 Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute 23430 Tenodesis of long tendon of biceps 23440 Resection or transplantation of long tendon of biceps 29825 Arthroscopy, shoulder, surgical

2017 AIM Specialty Health

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