Sonography and MRI Appearance of Proximal Long Head Biceps Tendon

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Thanis Saksirinukul


This article delves into the intricate anatomical structure and diagnostic imaging of the proximal long head biceps tendon, shedding light on its complexities and pathologies. Employing both ultrasound (us) and magnetic resonance imaging (MRI), the study illustrates the normal appearance of the tendon and explores detailed imaging findings for identifying abnormalities. The discussion encompasses tendinopathy, tears, biceps reflection pulley lesions, and superior labrum anterior-to- posterior lesions. By elucidating these aspects, the article aims to enhance diagnostic accuracy and inform treatment planning for a spectrum of conditions involving the proximal long head biceps tendon.

The proximal long head biceps tendon is a complex anatomical structure in shoulder imaging. Pathologies of the biceps tendon and adjacent structures, such as rotator cuff tendons and labrum, can affect treatment options and strategies. Secondary biceps tendon injury is more common than primary biceps tendon injury -biceps tendon injury is coexisted with rotator cuff tendon tear in 90% approximately. Diagnostic imaging as MRI is the preferred modality for visualizing all parts of the biceps tendon and detecting abnormalities. Ultrasound is also easily accessible and can provide good visualization of some parts of the proximal biceps tendon. This article discusses how to identify abnormalities on both MRI and ultrasound findings, for diagnosis and treatment planning. 


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Saksirinukul T. Sonography and MRI Appearance of Proximal Long Head Biceps Tendon. BKK Med J [Internet]. 2023 Sep. 30 [cited 2023 Dec. 6];19(2):128. Available from:
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