Best Practice Case Studies-Case 154 Asset 7 Ultrasound

Video Transcription

Video Summary

The presentation covered proximal long head biceps tendinosis and instability, emphasizing that biceps pathology is often associated with rotator cuff disease, especially subscapularis tears. Dr. Olifade reviewed anatomy, explaining that the biceps is stabilized less by the transverse humeral ligament and more by a soft pulley system involving the superior glenohumeral ligament, coracohumeral ligament, subscapularis, and supraspinatus.<br /><br />He discussed clinical categories of biceps pathology: instability, inflammatory/tendinopathic, and traumatic (partial or complete tear). A 57-year-old man with chronic anterior shoulder pain was presented as a case example. Physical exam maneuvers such as Speed’s and Yergason’s tests were reviewed, along with X-ray findings and the greater accuracy of ultrasound for diagnosing biceps pathology. He outlined a comprehensive shoulder ultrasound protocol, scanning the anterior, lateral, posterior, and joint structures, not just the biceps alone.<br /><br />Ultrasound findings were described for tenosynovitis, partial tear, full rupture, subluxation, and dislocation. Literature suggests ultrasound is highly accurate for instability and complete tears, but less reliable for partial tears and tendinopathy. The case patient ultimately had mild subluxation and tenosynovitis without full rupture and chose PRP injection. The discussion ended with recommendations for treatment ranging from conservative care to surgical referral in selected cases.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 154

Topic Shoulder

Keywords

4th Edition

4th Edition, Case 154

Shoulder

proximal long head biceps

biceps tendinosis

biceps instability

rotator cuff disease

subscapularis tear

shoulder ultrasound

tenosynovitis

PRP injection