Case report: Sonographic diagnosis of biceps tendon dislocation

Abstract

We report the sonographic findings in a case of medial dislocation of the long head of biceps tendon. Sonographic signs included an empty bicipital groove and sulcus with medial dislocation of the long head of biceps tendon. This tendon was found below the bicipital groove and luxation was not reducible during internal rotation of the arm. It appeared swollen and surrounded by a hypoechogenic effusion within the tendon sheath. The rotator cuff had normal thickness and echogenicity. We conclude that dislocation of biceps tendon can be reliably diagnosed with ultrasound. The use of CT arthrography and MRI should be limited to supplement inconclusive sonographic studies. Dislocation of the long head of biceps tendon out of the bicipital groove is an uncommon cause of shoulder pain. Clinical diagnosis may be difficult since biceps tendon dislocation is commonly associated with a rotator cuff tear and has a similar clinical presentation [1,2]. A variety of diagnostic imaging modalities, including arthrography, CT arthrography and magnetic resonance (MR) imaging has been used in identifying this condition [1 6]. Surprisingly, little attention has been paid to ultrasound (US) in this field, although US is considered one of the preferred diagnostic procedures in examining the shoulder. We report the US findings in a case of medial dislocation of the long head of biceps tendon diagnosed with US. DISCUSSION