Gregory Chang MD, Presenter: Nothing to Disclose

Catherine Petchprapa, Abstract Co-Author: Nothing to Disclose

Sandra Leigh Moore MD, Abstract Co-Author: Nothing to Disclose

Mark E. Schweitzer MD, Abstract Co-Author: Nothing to Disclose

Biceps dislocations, but not other forms of displacement have been fairly well studied. There is little data as to patterns, associations, and in particular the locations of the tendon relative to the subscapularis. We performed a large retrospective review focusing on these issues.

We reviewed 2468 consecutive shoulder MRI reports from our institution over a 2 year period and selected all cases describing biceps tendon displacement(n=103 at 1.5T). Two independent MSK radiologists reviewed the images and assessed for:biceps tendon subluxation v. dislocation; position of the biceps tendon(superfical=Sf, within=W/in, or deep=Dp to the subscapularis tendon); biceps, subscapularis, and supraspinatus/infraspinatus tendonopathy; presence of a joint effusion.

There were 31 dislocations(30%) and 72 subluxations(70%), all anteromedial. Comparing dislocations v. subluxations, 13% v. 49% were Sf, 26% v. 20% were W/in, and 61% v. 7% were Dp to the subscapularis tendon. 53% of Dp dislocations(10/19) were intra-articular. In 24% of all subluxations the biceps tendon was displaced, but did not overlap the subscapularis tendon. There was subscapularis tendonopathy in 87% of dislocations and 33% of subluxations. Comparing dislocations to subluxations in these cases, 11% v. 54% were Sf, 37% v. 21% were W/in, 52% v. 13% were Dp to the abnormal subscapularis tendon, and in 12% of subluxations the biceps tendon was displaced, but did not overlap the abnormal subscapularis tendon. There was increased frequency of biceps(71% v. 36%) and rotator cuff tendonopathy(94% v. 80%), and effusion(77% v. 43%) in dislocations v. subluxations.

Biceps tendon dislocation is less frequent than subluxation, but is more frequently associated with biceps and rotator cuff tendonopathy, and joint effusions-likely indicative of a later stage and more active disorder. Intra- and deep to the subscapularis tendon displacement is more frequent in biceps tendon dislocations than subluxations, and has not been previously described.

Intra- and deep to the subscapularis tendon displacement is more frequent in biceps tendon dislocations than subluxations. This knowledge may impact diagnosis of shoulder disorders.

Chang, G, Petchprapa, C, Moore, S, Schweitzer, M, A Systematic Analysis of Biceps dDsplacements with a Focus on Associations and Location Relative to the Subscapularis.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5006314.html