The biceps tendons: From the top and from the bottom

Area of Science:

• Musculoskeletal Imaging
• Anatomy
• Diagnostic Ultrasound

Background:

• The biceps brachii muscle has complex proximal and distal tendons with unique anatomical features.
• These peculiarities make sonographic examination challenging and prone to variability.
• Biceps tendon lesions can be misdiagnosed based on clinical findings alone.

Purpose of the Study:

• To detail the sonographic examination protocol for the biceps brachii tendon.
• To highlight the anatomical variations and potential pitfalls in ultrasound assessment.
• To emphasize the role of ultrasound in diagnosing biceps tendon pathologies.

Main Methods:

• Systematic sonographic evaluation of the biceps brachii tendon across nine defined zones.
• Detailed description of proximal and distal tendon anatomy, including the short and long heads, distal bifurcation, and lacertus fibrosus.
• Correlation of sonographic findings with potential pathologies.

Main Results:

• The study outlines specific sonographic landmarks and techniques for examining the biceps tendon.
• It identifies nine zones of interest crucial for comprehensive evaluation.
• The complex anatomy, particularly of the distal tendon, requires meticulous sonographic assessment.

Conclusions:

• Ultrasound is an indispensable tool for evaluating biceps brachii tendon lesions.
• A thorough understanding of biceps tendon anatomy and sonographic technique is vital for accurate diagnosis.
• Proper sonographic examination, especially of the distal biceps tendon, is critical and cannot be improvised.