Bicipital Tendon Injuries Workup

Updated: Jul 14, 2022
  • Author: John P Salvo, Jr, MD, MS; Chief Editor: Harris Gellman, MD  more...
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Imaging Studies

Plain radiography is a necessary part of a complete evaluation. Radiographs can reveal a bony avulsion from the radial tuberosity, but they are often negative. Mild-to-moderate underlying degenerative changes are not a contraindication for reconstruction of acute tears. [25]

Magnetic resonance imaging (MRI) can be helpful in cases of partial rupture of the tendon or in cases of chronic disruption or when the diagnosis is uncertain, but it otherwise has not been considered essential for the diagnosis and treatment of acute injuries. However, some feel that MRI may be the optimal imaging modality for distal biceps tendon tears. [26]  Rosenthal et al comprehensively reviewed the normal, abnormal, and postoperative appearance of the proximal [27] and distal [28] biceps brachii on MRI.

Ultrasonography (US) has been suggested as potentially useful for the evaluation of traumatic distal biceps brachii tendon injuries. [29] In a study of 120 patients with traumatic injuries of this type, de la Fuente et al compared US results with MRI results when surgery was not indicated and with MRI and surgical results when surgery was indicated. [30]  For major injuries, US had a slight but statistically significant advantge over MRI; however, for minor injuries, no clear advantage was apparent.