Head Of Biceps Research Articles

Surface Mapping of Motor Points in Biceps Brachii Muscle

ObjectiveTo localize the site of motor points within human biceps brachii muscles through surface mapping using electrophysiological method.MethodWe recorded the compound muscle action potentials of each lattice of the biceps brachii in 40 healthy subjects. Standardized reference lines were made as the following: 1) a horizontal reference line (elbow crease) and 2) a vertical reference line connecting coracoid process and mid-point of the horizontal reference line. The Compound muscle action potentials were mapped in reference to the standardized reference lines. The locations of motor points were mapped to the skin surface, in the ratio to the length of the vertical and the half of the horizontal reference lines.ResultsThe motor point of the short head of biceps was located at 69.0±4.9% distal and 19.1±9.5% medial to the mid-point of horizontal reference line. The location of the motor point of the long head of the biceps was 67.3±4.3% distal and 21.4±8.7% lateral. The motor point of the short head of the biceps was located more medially and distally in the male subjects compared to that in the female (p<0.05).ConclusionThis study showed electrophysiological motor points of the biceps brachii muscles through surface mapping. This data might improve the clinical efficacy and the feasibility of motor point targeting, when injecting botulinum neurotoxin in biceps brachii.

Symptomatic chronic long head of biceps rupture: Surgical results

Purpose:Chronic rupture of the long head of biceps (LHB) tendon is usually asymptomatic. However, some active patients suffer with long-term cramping pain associated with repetitive biceps use. The aim of this study is to review the outcomes of biceps tenodesis performed for chronic LHB ruptures.Materials and Methods:We performed a retrospective review of 11 consecutive patients who underwent biceps tenodesis for symptomatic chronic LHB ruptures over a 4-year period.Results:There were 10 men and one woman with an average age at surgery of 41 years (range 23-65). The mean follow-up was 29 months (range 6-60). In five cases a tendon was still identifiable and suitable for repair with an ‘in-bone’ interference screw. However, in six cases the tendon was not possible to tenodese with an interference screw. In these cases we used an ‘on-bone’ technique with suture anchors. All, except one, patients reported improvement in their arm pain (78%), strength (74%) and appearance. All, except one, were glad to have had the surgery.Conclusions:Symptomatic chronic LHB ruptures improve with a biceps tenodesis procedure. Due to the chronicity of the injury and possible degeneration of the tendon, a suitable tendon for ‘in-bone’ tenodesis may not be possible. In these cases an ‘on-bone’ footprint repair with suture anchors achieves good results.Level of Evidence:IV (retrospective case series).

Irreducible Traumatic Anterior Shoulder Dislocation Secondary to Both Subscapularis and Long Head of Biceps Tendon Interposition—A Case Report

An Irreducible dislocation of the shoulder is an uncommon event. When it does occur, blocks to reduction can include bone, labrum, rotator cuff musculature or tendon. Patients older than 40 at the time of initial dislocation are at increased risk of sustaining a concomitant rotator cuff tear. We present a case of an irreducible anterior shoulder dislocation due to interposition of both subscapularis tendon and a posteriorly dislocated long head of biceps. Both Computed Tomography (CT) and magnetic resonance imaging (MRI), along with intraoperative findings are discussed. Conclusion: We would advocate maintaining a low threshold for MR imaging post shoulder dislocation in the older population, when there is radiological or clinical concern regarding the integrity of the rotator cuff, and also to evaluate whether a concentric reduction of the shoulder joint has been achieved.

The development of an in vitro glenohumeral testing rig

Until recently the accurate measurement of contact loads acting in the glenohumeral joint have been difficult to calculate and define. Now, contact forces and moments are measured in vivo using telemeterised shoulder implants. This method limits testing opportunities so a dynamic shoulder testing apparatus has been developed to examine glenohumeral joint motion and forces. This in vitro study evaluated the accuracy of forces generated in the glenohumeral joint using an instrumented prosthetic implant. Forces were applied to cables to simulate loading of the supraspinatus, subscapularis, infraspinatus/teres minor, long head biceps and anterior, middle, and posterior deltoid muscles. The test rig reproduces the 6DoF of the glenohumeral joint and accurately recreates the contact forces measured in vivo. This test rig will allow many more tests to be simulated including comparison of fixation methods and high impact injuries.

Anterior shoulder pain due to persistence of a septum between long head biceps tendon and intra-articular supraspinatus

Few embryologic anomalies of the long head of the biceps (LHB) tendon have been described in the literature, among which are absence of the LHB, bifurcate origin of the tendon,2 a split LHB tendon in a single origin from supraglenoid tubercle,3 and an intra-capsular or extra-capsular origin of this structure. Arthroscopy is a helpful tool to address these anatomic shoulder variants, and arthroscopic surgeons should recognize all varieties of the shoulder’s intra-articular structures. The study of morphologic development in this area is the one method that allows surgeons to improve their clinical knowledge, possibly yielding better results for their patients.

Regarding: Humeral head abrasion: an association with failed superior labrum anterior posterior repairs

We are writing this letter in reference to the recently published study by Byram et al,1Byram I.R. Dunn W.R. Kuhn J.E. Humeral head abrasion: an association with failed superior labrum anterior posterior repairs.J Shoulder Elbow Surg. 2011; 20: 92-97https://doi.org/10.1016/j.jse.2010.05.013Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar who evaluated a significant association of a humeral head abrasion underneath the long head of the biceps tendon (LHB) and failed superior labrum anterior posterior (SLAP) repairs. Interestingly, the authors found significantly associated humeral chondral lesions in failed SLAP repairs but not in untreated SLAP lesions, as we did. In our own series, we evaluated 182 SLAP lesions in 3395 consecutive shoulder arthroscopies.6Patzer T. Lichtenberg S. Kircher J. Magosch P. Habermeyer P. Influence of SLAP lesions on chondral lesions of the glenohumeral joint.Knee Surg Sports Traumatol Arthrosc. 2010; 18 (doi 10.1007/s00167-009-0938-2): 982-987Crossref PubMed Scopus (33) Google Scholar We thereby observed a significant association of humeral chondral lesions typically located underneath the LHB with nonoperatively treated SLAP lesions in about 20% compared with less than 5% without a SLAP lesion present. The association of SLAP lesions with glenohumeral chondral lesions was confirmed by a clinical and magnetic resonance imaging arthrography-controlled study by Lehmann et al,3Lehmann L.J. Dinter D. Monateseri S. Scharf H.P. Weckbach S. Osteoarthritis after SLAP lesion? Clinical and arthro-MRI evaluation after arthroscopic SLAP refixation.Sportverletz Sportschaden. 2009; 23 (doi 10.1055/s-0028-1109541): 155-160Crossref PubMed Scopus (8) Google Scholar who evaluated glenohumeral chondral lesions after failed as well as after not-failed SLAP repairs. In addition to that, we have typically observed anteriorly located chondral lesions of the glenoid in untreated SLAP lesions as well. It would be of interest to the readership of the Journal of Shoulder and Elbow Surgery whether the referenced study could confirm our observations of a localized chondral lesion at the anterior glenoid rim. In a subsequent biomechanical study4Patzer T. Habermeyer P. Hurschler C. Bobrowitsch E. Paletta J.R. Fuchs-Winkelmann S. et al.Increased glenohumeral translation and biceps load after SLAP lesions with potential influence on glenohumeral chondral lesions: a biomechanical study on human cadavers.Knee Surg Sports Traumatol Arthrosc. 2011; ([Epub ahead of print]. doi 10.1007/s00167-011-1423-2)Google Scholar on human cadavers, we looked for an explanation for our findings. We evaluated the well-known increasing anterior, anterosuperior and anteroinferior shoulder instability after SLAP lesions as well as a consecutively increasing LHB load after SLAP lesions. Thus, we have postulated that the combination of an increased anterior shoulder instability and the increased LHB load might be responsible for the humeral head abrasion in the form of the LHB acting as a windshield wiper on the humeral head. The typical chondral lesion at the glenoid rim might be explained by the increased anterior instability after SLAP lesions. However, based on our clinical study,5Patzer T. Kircher J. Lichtenberg S. Sauter M. Magosch P. Habermeyer P. Is there an association between SLAP lesions and biceps pulley lesions?.Arthroscopy. 2011; 27: 611-618https://doi.org/10.1016/j.arthro.2011.01.005Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar we could not confirm the study of Castagna et al,2Castagna A. Mouhsine E. Conti M. Vinci E. Borroni M. Giardella A. et al.Chondral print on humeral head: an indirect sign of long head biceps tendon instability.Knee Surg Sports Traumatol Arthrosc. 2007; 15 (doi 10.1007/s00167-006-0211-x): 645-648Crossref PubMed Scopus (39) Google Scholar who evaluated a humeral chondral print in association with biceps pulley lesions. We only found an association of a humeral head abrasion with SLAP lesions but not with biceps pulley lesions. Thus, due to our clinical and biomechanical findings, an isolated LHB instability might not be the reason for the chondral lesion alone. It would be of interest if the referenced study could deliver some further information about the presence of biceps pulley lesions and a possible association with humeral chondral lesions. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Humeral head abrasion: An association with failed superior labrum anterior posterior repairsJournal of Shoulder and Elbow SurgeryVol. 20Issue 1PreviewAn abrasion on the humeral head under the articulating portion of the biceps tendon has been observed in patients with pain and stiffness after superior labrum anterior posterior (SLAP) repair. This study examined this humeral head abrasion (HHA) and its association with various diagnoses involving pathology of the biceps-labral complex. We hypothesized that it would be more common in failed SLAP repairs than other diagnoses. Full-Text PDF

Current practice in shoulder pathology: results of a web-based survey among a community of 1,084 orthopedic surgeons

The aim of this study was to report orthopedic surgeons' management of choice for difficult clinical scenarios of shoulder pathologies. A web questionnaire was developed including four clinical scenarios of shoulder pathologies. Subsequently, opinions were solicited from more than 1,000 members of an international association of surgeons specialized in sports traumatology and knee surgery (ESSKA). The response rate was 40% (412 questionnaires). For scenario 1, first anterior dislocation of the shoulder, the most indicated treatment for 71% of respondents was an arthroscopic Bankart repair (P < 0.001). For scenario 2, shoulder arthritis with concentric erosion and cuff tear, 38% chose a shoulder replacement, while 37% preferred a supraspinatus tendon repair in combination with long head of biceps (LHB) tenodesis or tenotomy. For scenario 3, large tendon tears with 70% fatty infiltration of the infraspinatus tendon and lateral LHB instability, 70% of surgeons considered that, among conservative treatments, hyaluronic acid injection was not an appropriate management. Arthroscopic rotator cuff repair, arthroscopic acromioplasty, and LHB tenotomy gained larger consensus (81, 80, and 79% of respondents, respectively). A double-row technique for rotator cuff repair was preferred to a single-row technique (P = 0.02). Scenario 4, adhesive capsulitis, split the respondents equally, with 51% in favor of a surgical approach and 49% in favor of a conservative approach (N.S.). On-line questionnaires have the potential to improve knowledge about current trends in clinical practice and can help orthopedic surgeons to develop guidelines. Cross-sectional; Level V (expert opinion).

Transtendon arthroscopic repair of high grade partial-thickness articular surface tears of the rotator cuff with biceps tendon augmentation: technical note and preliminary results

Partial articular surface of the rotator cuff tendon tears has been recognized as a source of treatable shoulder pain and a precursory pathology for full-thickness tendon tears. Arthroscopic rotator cuff repair is a possible surgical method of treatment. Recent data have shown that the treating partial-thickness rotator cuff repairs with transtendon technique shows good clinical outcome. The use of this technique enables the reconstitution of the tendon with complete reconstruction of its footprint without damaging its intact bursal part. In cases of high grade partial articular-sided degenerative rotator cuff tears (involving >50% of the tendon) in older patients, there is a possibility of poor healing or re-tear of the rotator cuff repair, which may be associated with poor tendon quality and substantial thinning of the rotator cuff, subsequently revision surgery in these patients will be demanding. To mitigate these problems, we describe here a new arthroscopic transtendon repair technique with tenotomized long head biceps tendon augmentation for high grade partial articular rotator cuff tear with the goal of providing increase tendon healing, as well as to minimize the probability of failure of the construct and to improve the clinical outcomes. The clinical results of the first 39 consecutive patients are reported showing significant decrease in pain and improved shoulder scores, as well as the post-operative range of motion and with no cases of re-tear of the rotator cuff tendon.

Modified Boytchev procedure for treatment of recurrent anterior dislocation of shoulder

Background:More than 200 different operations have been described for the treatment of recurrent anterior dislocation of shoulder. The Modified Boytchev procedure employs rerouting of the detached tip of coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis) deep to subscapularis and reattaches to its anatomical location. We conducted a study on evaluation of long-term effect of modified Boytchev procedure and to compare our results with other studies published in literature.Materials and Methods:Since June 2002, modified Boytchev procedure was performed on 48 patients, who presented with recurrent anterior dislocation. 45 were men and 3 were women and were in the age group of 18-40 years (mean 27.83±4.95 years). Forty patients were affected on the dominant side and rest on the non-dominant side. The mean number of dislocations in these patients was 18.22±12.08. The mean followup period was 58.13±19.06 months (range 18-96 months). The patients were evaluated by visual analogue score, modified American Shoulder and Elbow Surgeon's Score (ASES), and Single Assessment Numeric Evaluation (SANE) score at the last followup.Results:All the patients regained almost preoperative range of forward flexion at the last followup. In the preoperative period the mean external rotation deficit at 0° and at 90° of abduction was 13.22°±5.16° and 18.06°±6.50°, respectively. At the last followup, the mean external rotation deficit at 0° and at 90° of abduction was 8.06°±2.47° and 8.95°±2.07°, respectively. This improvement in external rotation deficit was statistically significant (P<.05). Preoperative scores were compared with the most recent followup scores for all variables with use of a paired t test. All patients had significant improvement in visual analogue score, modified American Shoulder and Elbow Surgeon's Score (ASES), and Single Assessment Numeric Evaluation (SANE) score at the last followup. Four of the patients developed superficial infection which got resolved after treating with antibiotics, and two of the patients developed transient musculocutaneous nerve paresis. There was no radiological evidence of loosening and migration of coracoid screw or any glenohumeral arthritis on subsequent followup of skiagrams in any of our patients.Conclusion:Modified Boytchev procedure is an efficacious and technically simple procedure to treat recurrent anterior dislocation of shoulder.

Instabilità antero-inferiore: l’intervento di Latarjet modificato

Shoulder instability is one of most controversial joint diseases in terms of diagnosis and treatment. Several open surgical treatments for primary anterior glenohumeral instability have been published, including long-term follow-up of these methods, which are reliable and time-tested and can yield excellent clinical results. The use of arthroscopy has improved the recognition of pathologic findings in shoulder instability and allowed a better understanding of the anatomopathology of instability and the correlation between symptoms and lesions. The arthroscopic technique allows reparative and reconstructive surgical procedures aimed at selective treatment of the injured structures, obviating tenotomy or splitting of the subscapularis, thus reducing the risk of iatrogenic damage. In international literature, some studies demonstrate the results of arthroscopic treatment of recurrent traumatic anterior instability comparable with those achieved historically with open procedures. Despite these exciting advances, open surgery remains an acceptable method of treatment, particularly when a surgeon lacks the equipment, experience, or technical skills needed to perform an arthroscopic repair. Moreover, open surgery remains the preferred method of treatment in situations in which arthroscopic techniques cannot adequately address the anatomic lesion, such as anterior instability in the presence of glenoid and/or humeral bony defects or soft tissue deficiencies. The Latarjet procedure, first described in 1958 and used to address anteroinferior shoulder instability, involves using coracoid transfer to stabilize the shoulder by the static action of the transferred bone block and by the dynamic action of the attached conjoined tendon sling (short head of biceps and coracobrachialis) in patients who present anteroinferior shoulder instability. There are different effects by which to achieve shoulder stability with the Latarjet procedure: a) bone effect: bone graft can prevent engagement of a humeral bone lesion because the graft extends the glenoid arch to such a degree that the shoulder cannot externally rotate far enough to engage the Hill-Sachs lesion over the front of the graft; b) muscle effect: transfer of a coracoid graft and conjoined tendon over the top of the lower subscapularis tendon results in increased tension in the inferior fibers of the subscapularis, enhancing anterior stability; c) sling effect: conjoined tendon forms a sling across the anterior-inferior capsule when the shoulder is in 90° abduction and 90° external rotation, providing additional soft tissue restraint anteriorly, all of which act to prevent engagement of the Hill-Sachs lesion even before the anterior capsule is repaired; d) capsular effect: follows capsular restoration.

Luxation irréductible de l’épaule – La prudence est de règle

Anterior dislocation of shoulder is usually amenable to closed manipulation. Failure to achieve satisfactory reduction can be due to soft tissue or osseous interposition. We report a case of irreducible anterior shoulder dislocation with the interposition of the musculocutaneous nerve. This required open reduction and release of the musculocutaneous nerve, which was found to be further trapped by the torn long head of biceps.

Irreducible shoulder dislocation – A word of caution

Anterior dislocation of shoulder is usually amenable to closed manipulation. Failure to achieve satisfactory reduction can be due to soft tissue or osseous interposition. We report a case of irreducible anterior shoulder dislocation with the interposition of the musculocutaneous nerve. This required open reduction and release of the musculocutaneous nerve; which was found to be further trapped by the torn long head of biceps.

Calcification of the Superior Glenoid Labrum

Calcific tendonitis predominantly affects the rotator cuff tendons. Other reported sites of occurrence include the tendon of the long head of biceps, the trapezius and pectoralis major muscles. We report a rare case of calcification within the posterosuperior glenoid labrum of the shoulder.

Anatomy, Function, Injuries, and Treatment of the Long Head of the Biceps Brachii Tendon

Lesions of the long head biceps tendon (LHB) are frequent causes of shoulder pain and disability. Biceps tenotomy and tenodesis have gained widespread acceptance as effective procedures to manage both isolated LHB pathology and combined lesions of the rotator cuff and biceps-labral complex. The function of the LHB tendon and its role in glenohumeral kinematics presently remain only partially understood because of the difficulty of cadaveric and in vivo biomechanical studies. The purpose of this article is to offer an up-to-date review of the anatomy and biomechanical properties of the LHB and to provide an evidence-based approach to current treatment strategies for LHB disorders.

Shoulder MRI accuracy in the community setting

Evaluate the accuracy for shoulder magnetic resonance imaging (MRI) interpretations of typical community radiologists and compare this to selected fellowship trained musculoskeletal radiologists. The MRIs of 104 shoulders of 100 consecutive different patients who had undergone shoulder arthroscopy by a single surgeon were included in this prospective study. The 104 typed MRI reports of community radiologists were examined, and the positive or negative findings were recorded for the anterior, superior, and posterior labra, and the long head biceps tendon and rotator cuff. The 104 MRIs were then interpreted by 2 fellowship trained musculoskeletal radiologists who were blinded to the nature of this study. They were asked to specifically comment on the same shoulder pathologies and to subjectively rate the quality of each MRI study using a visual analogue score (VAS). The shoulder pathologies documented by arthroscopy included rotator cuff tears (55 full, 10 partial), labral tears (12 anterior, 17 posterior, 29 superior), and 31 biceps abnormalities. There were 69 noncontrast MRIs and 35 MRI arthrograms. Comparing the community radiologists' accuracies with the 2 selected musculoskeletal radiologists' accuracies, there were no significant differences for any of the shoulder pathologies studied. There was a significant positive correlation between VAS and accuracies for both musculoskeletal radiologists in diagnosing posterior labral tears only. The use of contrast in these MRIs only significantly improved both of the musculoskeletal radiologists' accuracies in diagnosing biceps lesions. The accuracies for shoulder MRI in this community setting were not improved by having the MRIs interpreted by selected fellowship trained musculoskeletal radiologists.

The loop-the-loop stitch technique for long head of biceps tenodesis

We present a simple, reproducible and quick method of securing the intra-articular portion of the long head of biceps in preparation for tenodesis. Securing the long head of biceps from the joint with per-tendinous suture or simple loop can result in loss of the tendon down the groove, which can be difficult to retrieve. Arthroscopic passage of the loop-the-loop suture provides dependable, reproducible control of the biceps, and can be prepared for tenodesis by whatever subsequent method.

The use of Shoulder Ultrasound in a One-Stop Clinic: Diagnostic Accuracy for Rotator Cuff Tear and Biceps Tendon Pathology

Background Ultrasonography is useful in diagnosing rotator cuff tears in one-stop shoulder clinics. The present study aimed to investigate one-stop shoulder clinic ultrasonographic accuracy when diagnosing rotator cuff tears and their size, as well as long head of biceps (LHB) tendon pathology. Methods One hundred and twenty-two patients who underwent shoulder arthroscopy following pre-operative ultrasonography in a one-stop shoulder clinic were analyzed retrospectively. Results Partial thickness cuff tears were detected with a sensitivity and specificity of 65.0% and 94.0%, respectively, and full thickness tears at 94.8% and 93.8%, respectively. Full thickness tears were further analyzed as small tears, (&lt;1 cm), with a sensitivity and specificity of 50.0% and 96.6%, respectively; moderate (1 cm to 3 cm), at 88.5% and 93.8%, respectively; and large/massive tears (&gt;3 cm) at 73.1% and 99.0%, respectively. LHB pathology diagnosis sensitivity and specificity was 62.5% and 100%. Further analysis revealed a sensitivity and specificity of LHB dislocation of 83.3% and 100%, respectively, and rupture of 61.1% and 99.0%, respectively. Conclusions This is the first study to report shoulder ultrasonographic accuracy at a one-stop clinic when investigating cuff tear size and LHB pathology. Ultrasonography at a one-stop clinic is a cost-effective accurate method of managing patients with shoulder pathology.

Clinical and isokinetic comparison between tenotomy and tenodesis in biceps pathologies

The purpose of this study to compare clinical and isokinetic results of patients who underwent biceps tenotomy or tenodesis for chronic tenosynovitis. Arthroscopic biceps tenotomy, arthroscopy assisted or arthroscopic biceps tenodesis were done in 20 patients who had diagnosis of chronic tenosynovitis and in whom conservative treatment was not helpful. Rotator cuff repair and acromioplasty was performed in 18 patients and acromioplasty alone in two patients in addition to biceps surgery. Arthroscopic biceps tenotomy was done in 10 patients (5 female, 5 male; mean age 63, range 53-75), 10 patients underwent tenodesis out of which arthroscopy assisted biceps tenodesis was done in 8 patients and all arthroscopic biceps tenodesis was done in 2 patients (4 female, 6 male; mean age 57, range 49-66). All patients were evaluated with Constant and UCLA scores preoperatively and postoperatively. The average follow-up of the patients 3,1 years (between 1-8 years). Isokinetically elbow flexion and forearm supination were compared using the Cybex (Biodex 3, Cybex Biomedical System, NY, USA) machine. Pre-operative results of each group were compared with the postoperative results, using Mann-Whitney U test. Preoperative average constant scores of tenotomy group were 64.40, whereas postoperative scores were 89.50 (p=0.002), and preoperative average constant scores of tenodesis group were 62.80, whereas postoperative scores were 86.70 (p=0.003). Preoperative average UCLA scores of tenotomy group were 23.20 whereas postoperative UCLA scores 22.60 (p=0.003), preoperative average UCLA scores of tenodesis group were 30.00 whereas postoperative UCLA scores was 29.20 (p=0.004). In both groups statistically significant improvement of UCLA and Constant scores was detected. Comparison between Constant, UCLA scores and isokinetic measurements of both groups showed no statistically significant difference (p>0.05). No complication was noted. In the treatment of chronic tenosynovitis, biceps tenodesis and tenotomy of long head of biceps showed similar clinical, functional, isokinetic and cosmetic results. No Popeye deformity was seen in the tenotomy group.

Superior dislocation of glenohumeral joint with dislocation of long head biceps brachii&#151;A case report

Superior dislocation of glenohumeral joint with dislocation of long head biceps brachii&#151;A case report

Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

BackgroundThe prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus.MethodsThe study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively), who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans.ResultsTendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p < 0.001; Biceps Tendon: 4 ± 0.8 mm vs 3.2 ± 0.4 mm, p < 0.001). Sonographic appearances of degenerative features in the rotator cuff and biceps were more frequently observed in diabetics (Supraspinatus Tendon: 42.7% vs 20.3%, p < 0.003; Biceps Tendon: 27% vs 7.8%, p < 0.002).Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8%) vs 2 (3.1%), p < 0.03; Major tears: 15 (15.8%) vs 5 (7.8%), p = ns), but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p < 0.03) as well as tenosynovitis in biceps tendon (33.3% vs 10.9%, p < 0.001).In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found.ConclusionsOur results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics.Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.