Ultrasound demonstration of distal biceps tendon bifurcation: normal and abnormal findings.
ABSTRACT We demonstrate the US appearance of the distal biceps tendon bifurcation in normal cadavers and volunteers and in those affected by various disease processes. Three cadaveric specimens, 30 normal volunteers, and 75 patients were evaluated by means of US. Correlative MR imaging was obtained in normal volunteers and patients. In all cases US demonstrated the distal biceps tendon shaped by two separate tendons belonging to the short and long head of the biceps brachii muscle. Four patients had a complete rupture of the distal insertion of the biceps with retraction of the muscle belly. Four patients had partial tear of the distal biceps tendon with different US appearance. In two patients the partial tear involved the short head of the biceps brachii tendon, while in the other two patients, the long head was involved. Correlative MR imaging is also presented both in normal volunteers and patients. US changed the therapeutic management in the patients with partial tears involving the LH of the biceps. This is the first report in which ultrasound considers the distal biceps tendon bifurcation in detail. Isolated tears of one of these components can be identified by US. Knowledge of the distal biceps tendon bifurcation ultrasonographic anatomy and pathology has important diagnostic and therapeutic implications.
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ABSTRACT: We report a case of isolated rupture of the separate insertion of the short head of biceps on the radial tuberosity. This case occurred in a 52-year-old male fitness instructor who lifted a heavy weight. The patient presented with pain, bruising of the anterior elbow and weakness of elbow flexion. There was no bunching of the distal biceps and the hook test was normal. The rupture and location of the tendon ends was identified by several transverse and longitudinal ultrasound images and then definitively confirmed by magnetic resonance imaging. The rupture was surgically repaired, resulting in good functional ability. Early detection is vitally important for optimal management, especially when functional disability is present.Shoulder & Elbow 07/2013; 5(3).
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ABSTRACT: Abstract Objectives: Static and dynamic high-frequency ultrasound of healing rabbit Achilles tendons were set in relationship to histomorphometric analyses at three and six weeks post-surgery. Materials and Methods: Twelve New Zealand White rabbits received a clean-cut Achilles tendon laceration (the medial and lateral M. gastrocnemius) and were repaired with a 4-strand Becker suture. Six rabbits got additionally a tight polyester urethane tube at the repair site in order to vary the adhesion extent. Tendons were analyzed by static and dynamic ultrasound (control: healthy contralateral legs). The ultrasound outcome was corresponded to the tendon shape, tenocyte and tenoblast density, tenocyte and tenoblast nuclei width, collagen fibre orientation and adhesion extent. Results: The spindle-like morphology of healing tendons (ultrasound) was confirmed by the swollen epitenon (histology). Prediction of adhesion formation by dynamic ultrasound assessment was confirmed by histology (contact region to surrounding tissue). Hyperechogenic areas corresponded to acellular zones with aligned fibres and hypoechogenic zones to not yet oriented fibres and to cell rich areas. Conclusions: These findings add new in-depth structural knowledge to the established non-invasive analytical tool, ultrasound.Connective tissue research 11/2013; · 1.98 Impact Factor
Article: Bursopatías: formas topográficas[Show abstract] [Hide abstract]
ABSTRACT: El aparato locomotor garantiza su motricidad a través de la unidad musculotendinosa, de la cual el músculo constituye el elemento motor. El tendón no sólo asegura la transmisión al esqueleto, sino que también tiene funciones importantes de absorción de las tensiones y de restitución de la energía gracias a su elastoviscosidad. Sin embargo, el tendón necesita estructuras de deslizamiento, vainas sinoviales y bolsas serosas, así como poleas o retináculos, que permitan la reflexión y el mantenimiento del tendón y su vaina cuando se deslizan sobre otro tendón que lo cruza, sobre una superficie ósea en un trayecto intraarticular o en el caso de un trayecto que abarque varias articulaciones con cambios de dirección. Estas estructuras de deslizamiento son fuente de múltiples enfermedades debidas a traumatismos o microtraumatismos o secundarias a una enfermedad general. Estas enfermedades repercutirán sobre la función o la estructura del tendón y causarán dolor o impotencia funcional. Se abordarán aquí las formas topográficas de las bursopatías y se destacarán algunas características clínicas, diagnósticas o terapéuticas.EMC - Aparato Locomotor. 09/2014; 47(3):1–8.