HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Buck, F. M. Articles by Hodler, J. PubMed PubMed Citation Articles by Buck, F. M. Articles by Hodler, J. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Degeneration of the Long Biceps Tendon: Comparison of MRI With Gross Anatomy and Histology

¹ Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, 8008 Zurich, Switzerland.
² Department of Orthopedics, Orthopedic University Hospital Balgrist, Zurich, Switzerland.
³ Institute of Veterinary Pathology, Vetsuisse Faculty Zurich, Zurich, Switzerland.
⁴ Musculoskeletal Research Unit, Vetsuisse Faculty Zurich, Zurich, Switzerland.

OBJECTIVE. The objective of our study was to relate alterations in biceps tendon diameter and signal on MR images to gross anatomy and histology.

MATERIALS AND METHODS. T1-weighted, T2-weighted fat-saturated, and proton density–weighted fat-saturated spin-echo sequences were acquired in 15 cadaveric shoulders. Biceps tendon diameter (normal, flattened, thickened, and partially or completely torn) and signal intensity (compared with bone, fat, muscle, and joint fluid) were graded by two readers independently and in a blinded fashion. The distance of tendon abnormalities from the attachment at the glenoid were noted in millimeters. MRI findings were related to gross anatomic and histologic findings.

RESULTS. On the basis of gross anatomy, there were six normal, five flattened, two thickened, and two partially torn tendons. Reader 1 graded nine diameter changes correctly, missed two, and incorrectly graded four. The corresponding values for reader 2 were seven, one, and five, respectively, with = 0.75. Histology showed mucoid degeneration (n = 13), lipoid degeneration (n = 7), and fatty infiltration (n = 6). At least one type of abnormality was found in each single tendon. Mucoid degeneration was hyperintense compared with fatty infiltration on T2-weighted fat-saturated images and hyperintense compared with magic-angle artifacts on proton density–weighted fat-saturated images. MRI-based localization of degeneration agreed well with histologic findings.

CONCLUSION. Diameter changes are specific but not sensitive in diagnosing tendinopathy of the biceps tendon. Increased tendon signal is most typical for mucoid degeneration but should be used with care as a sign of tendon degeneration.

Keywords: degeneration • long biceps tendon • MRI

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?