Diane Bergin MD, Presenter: Nothing to Disclose

William Brian Morrison MD, Abstract Co-Author: Nothing to Disclose

Adam C. Zoga MD, Abstract Co-Author: Nothing to Disclose

Timothy G. Sanders MD, Abstract Co-Author: Nothing to Disclose

Determine by MR the pattern of biceps tendon displacement relative to the deep and superficial fibers of the subscapularis and associated osseous findings at their attachment.

Two musculoskeletal radiologists reviewed fifty-six 1.5T MR shoulder exams (29M: 27F;mean age 42) with displacement of the biceps tendon reported in our database over 3 years. The biceps was recorded as normal, tendonotic or torn. Location of the biceps relative to the groove and subscapularis(superficial, within, or deep to the tendon) was noted. The superficial (including the transverse ligament) and deep fibers of both bundles of the subscapularis were graded as intact or torn. Bone proliferation and cysts at the attachments of the subscapularis tendon were noted.

The biceps tendon was normal (23%), tendonotic (68%) or torn (9%). At the superior bundle of the subscapularis the biceps tendon was in the groove (2%), subluxed into(61%)and deep to the tendon (5%), dislocated superficial to the tendon (2%), into the tendon (5%), deep to the tendon (21%) and indeterminate (4%). At the inferior bundle the biceps was in the groove (36%), subluxed into(32%)and deep to the tendon(5%), dislocated superficial to (2%),into (9%) and deep to the tendon (16%).The superficial and deep attachments of the superior /inferior bundle of the subscapularis tendon were intact in 5%/20%; torn in 25%/20%. The superficial fibers were intact with deep torn in 36% /30%, the superficial fibers were torn and deep intact in 16%/14%. The subscapularis muscle was normal (50%), reduced in size (5%) and had fatty atrophy (45%). Bone proliferation was noted at the superficial/deep attachments in 64%/71% with associated tears 70%/59%. Cysts were noted at the superficial/deep attachment in 41%/43%. There was significant correlation between presence of bone proliferation at the deep attachment and tear of the deep fibers (r =0.7) and at the superficial attachment with tear of the superficial fibers (r=0.6)

The most frequent patterns of biceps displacement were subluxation into or deep to the subscapularis tendon. Both were most commonly associated with tear of the deep fibers of the subscapularis and bone proliferation.

Bergin, D, Morrison, W, Zoga, A, Sanders, T, Patterns of Biceps Tendon Displacement and Associated Subscapularis Tendon and Osseous Pathology on MR Imaging of the Shoulder.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409797.html