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Long Head Biceps Subluxation
 

Author: Jonathan Mason, DO
Affiliation: Wake Forest University
Co Author(s): Christopher Miles, MD FAMSSM
Senior Editor: Laura Mattson, DO

Clinical Vignette: A tennis player with worsening right shoulder pain for 3 months, presented for concern of biceps tendonitis. Speed's test and Yergason's test were positive.

Type of Probe Used: L15 5-15 MHZ linear array transducer



Long axis view of the bicipital groove between the greater tuberosity and lesser tuberosity of the humerus. Note that the groove still has a hyperechoic appearance. This can deceive the scanner to believe that the long head of the biceps is still within the groove.
View Video

Short axis view beginning at the intersection of the long head of the biceps tendon with the pectoralis major, and then gliding proximally in the short axis towards the rotator interval.
View Video

Short axis view beginning at the intersection of the long head of the biceps tendon with the pectoralis major, and then gliding proximally in the short axis towards the rotator interval. Note the occasional transducer tilt to account for anisotropy of the long head of the biceps as the scan glides proximally.


Long axis view of the bicipital groove between the greater tuberosity and lesser tuberosity of the humerus.


Short axis view of the long head of the biceps that is subluxed medially and is positioned superficial to the subscapularis and deep to the deltoid. The coracoid process is on the left side of the picture (medial) and is at the level of the coracohumeral ligament.


Short axis view of the long head of the biceps that is subluxed medially superficial to the subscapularis.


Short axis view of the long head of the biceps with the coracoid process visualized.


Short axis view of the long head of the biceps at the level of the biceps groove and subscapularis.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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