Sonography of Tears of the Distal Biceps Tendon
Theodore T. Miller1,2 and
Ronald S. Adler3
1
North Shore Imaging Associates, P.C., 825 Northern Blvd., Great Neck, NY
10021.
2
Department of Radiology, North Shore University Hospital, 300 Community Dr.,
Manhasset, NY 11030.
3
Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th
St., New York, NY 10021.
View larger version (131K):
[in a new window]
|
Fig. 1A. —Photographs of position of sonographic transducer. Longitudinal
image of tendon is obtained by aligning transducer slightly inferolaterally to
long axis of forearm.
|
|
View larger version (137K):
[in a new window]
|
Fig. 1B. —Photographs of position of sonographic transducer. Transverse image
is obtained by aligning transducer perpendicular to long axis of forearm.
Forearm should be maximally supinated and transducer "heel-toed"
into interosseous space.
|
|
View larger version (104K):
[in a new window]
|
Fig. 2A. —47-year-old man with surgically proven rupture and retraction of
distal biceps tendon. Longitudinal sonogram of contralateral normal right
elbow shows distal biceps tendon (short arrows) inserting on
bicipital tuberosity (long arrow). Distal aspect of tendon has areas
of decreased echogenicity due to anisotropy. Note radial head (H) and radial
neck (N).
|
|
View larger version (115K):
[in a new window]
|
Fig. 2B. —47-year-old man with surgically proven rupture and retraction of
distal biceps tendon. Longitudinal sonogram of affected left elbow shows torn
and retracted tendon edge (black arrow) with hypoechoic fluid (f) in
gap. Note radial head (H), radial neck (N), and bicipital tuberosity
(white arrow).
|
|
View larger version (123K):
[in a new window]
|
Fig. 2C. —47-year-old man with surgically proven rupture and retraction of
distal biceps tendon. Sagittal fat-suppressed fast spin-echo T2-weighted MR
image (TR/TEeff, 4000/45; echo train length, eight) of affected
left elbow shows torn and retracted tendon (straight black arrow) and
surrounding high-signal-intensity edema and hemorrhage (curved black
arrow). Note capitellum (C), radial head (H), radial neck (N), and
bicipital tuberosity (white arrow).
|
|
View larger version (154K):
[in a new window]
|
Fig. 3. —51-year-old man with surgically confirmed ruptured and retracted
distal biceps tendon. Longitudinal sonogram at level proximal to elbow joint
shows retracted tendon edge (arrow) with hypoechoic fluid (f) in gap.
Note brachialis muscle (B). Contralateral elbow was not scanned.
|
|
View larger version (109K):
[in a new window]
|
Fig. 4A. —44-year-old man with retracted tear of most of distal tendon.
Longitudinal sonogram of contralateral normal right elbow shows distal biceps
tendon (short arrows) inserting on bicipital tuberosity (long
arrow).
|
|
View larger version (135K):
[in a new window]
|
Fig. 4B. —44-year-old man with retracted tear of most of distal tendon.
Longitudinal sonogram of affected left elbow shows retracted tendon edge
(black arrow) with thin strand of tendon (small white
arrows) remaining attached to bicipital tuberosity (large white
arrow). Hypoechoic fluid (F) surrounds remaining strand of tendon. Note
trochlea (T).
|
|
View larger version (95K):
[in a new window]
|
Fig. 4C. —44-year-old man with retracted tear of most of distal tendon.
Sagittal fat-suppressed fast spin-echo T2-weighted MR image
(TR/TEeff, 4300/48; echo train length, eight) of affected left
elbow shows torn and retracted tendon (straight white arrow) and thin
strand of remaining tendon (black arrows) with surrounding
high-signal-intensity edema and hemorrhage. Note bicipital tuberosity
(curved white arrow) and trochlea (T).
|
|
View larger version (109K):
[in a new window]
|
Fig. 4D. —44-year-old man with retracted tear of most of distal tendon. Axial
fat-suppressed fast spin-echo T2-weighted MR image (TR/TE, 5000/45; echo train
length, eight) of left elbow shows cross section of thin strand of remaining
distal tendon (arrow) with surrounding high-signal-intensity fluid.
At surgery 12 days later, tendon was completely ruptured.
|
|
View larger version (131K):
[in a new window]
|
Fig. 5A. —57-year-old man with surgically confirmed partial tear of distal
biceps tendon. Longitudinal sonogram of contralateral normal right elbow shows
biceps tendon (thin arrows) inserting on biciptal tuberosity
(thick arrow). Note radial head (H) and radial neck (N).
|
|
View larger version (135K):
[in a new window]
|
Fig. 5B. —57-year-old man with surgically confirmed partial tear of distal
biceps tendon. Longitudinal sonogram of affected left elbow shows thickened
and wavy tendon (thin arrows) inserting on tuberosity (thick
arrow). Note radial head (H) and radial neck (N).
|
|
View larger version (166K):
[in a new window]
|
Fig. 5C. —57-year-old man with surgically confirmed partial tear of distal
biceps tendon. Transverse sonogram of normal right elbow shows tendon
(black arrows) inserting on tuberosity (white arrow). Tendon
is hypoechoic because of anisotropy. Image was photographed reversed to
facilitate comparison with Figure
4D.
|
|
View larger version (158K):
[in a new window]
|
Fig. 5D. —57-year-old man with surgically confirmed partial tear of distal
biceps tendon. Transverse sonogram of affected left elbow shows thickened and
echogenic distal tendon (black arrows) inserting on tuberosity
(white arrow).
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2000 by the American Roentgen Ray Society.
