Abstract
ObjectiveThe present work is aimed at analysing ultrasound findings in patients with distal biceps brachii tendon (DBBT) injuries to assess the sensitivity of ultrasound in detecting the different forms of injury, and to compare ultrasound results with magnetic resonance imaging (MRI) and surgical results.Materials and methodsA total of 120 patients with traumatic DBBT injuries examined between 2011 and 2015 were analysed. We compared ultrasound results with MRI results when surgery was not indicated and with MRI and surgical results when surgery was indicated.ResultsFor major DBBT injuries (complete tears and high-grade partial tears), the concordance study between exploration methods and surgical results found that ultrasound presented a slight statistically significant advantage over MRI (ultrasound: κ = 0.95—very good—95% CI 0.88 to 1.01, MRI: κ = 0.63—good—95% CI 0.42 to 0.84, kappa difference p < 0.01). Minor injuries, in which most tendon fibres remain intact (tendinopathies, elongations and low-grade partial tears), are the most difficult to interpret, as ultrasound and MRI reports disagreed in 12 out of 39 cases and no surgical confirmation could be obtained.ConclusionsBased on present results and previous MRI classifications, we establish a traumatic DBBT injury ultrasound classification. The sensitivity and ultrasound–surgery correlation results in the diagnosis of major DBBT injuries obtained in the present study support the recommendation that ultrasound can be used as a first-line imaging modality to evaluate DBBT injuries.
Highlights
Distal biceps brachii tendon (DBBT) injuries occur mainly in men aged 40–60 years
The DBBT is composed of two main functionally independent components: a tendon mainly arising from the short head of the biceps brachii muscle and another arising from the long head of the biceps brachii muscle [6]
Besides the DBBT, the biceps brachii muscle attaches distally by means of the bicipital aponeurosis, known as the lacertus fibrosus, which is a complex fibrous structure that arises medial to the DBBT at the myotendinous junction of the biceps brachii muscle and it runs medial to merge with the antebrachial fascia [5]
Summary
Distal biceps brachii tendon (DBBT) injuries occur mainly in men aged 40–60 years. The main injury mechanism is an intense extension force applied to the anterior aspect of the forearm with the elbow in an active flexed position [1,2,3,4]. The DBBT is composed of two main functionally independent components: a tendon mainly arising from the short head of the biceps brachii muscle and another arising from the long head of the biceps brachii muscle [6]. Both components are surrounded by a single paratenon [9], which can contain peritendinous fluid or effusion surrounding the whole tendon in acute traumatic injuries such as partial tears [10]. We refer to this aponeurosis as the external bicipital aponeurosis (EBA) to differentiate it from the internal or intramuscular bicipital aponeurosis (IBA)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
