Long head of the biceps tenosynovitis

Tenosynovitis and effusion of the long head of the biceps tendon sheath

Clinical information

The patient had a pain in her right shoulder for some weeks. The onset was gradual. The left shoulder was unaffected.

Brief description

Analyzing the images according to the SonoSkills pathology checklist the following items are being scored:
1. Shape: the tendon sheath has swollen; the sheath has a convex appearance. The bursa SASD has increased in thickness. The long head of the biceps tendon appears to be normal.
2. Echogenicity: an anechoic zone can be seen surrounding the biceps: a biceps halo. This appears to be an effusion. The bursa SASD contains a hyperechoic substance, possibly some synovial proliferation. The biceps tendon appears to be normal.
3. Continuity: all fibers of tissues which are visualized seem to be intact.
4. Doppler: a positive power Doppler signal in the tendon sheath can be seen.
5. Function: no functional problems where seen during ultrasound guided examination.

Ultrasound Images & Clips

Transverse image proximal tendon/proximal part and bursa with power Doppler
Transverse image proximal tendon/proximal part and bursa with power Doppler
Transverse image proximal tendon/distal part
Transverse image proximal tendon/distal part
Transverse image left/right comparison proximal tendon/distal part
Transverse image left/right comparison proximal tendon/distal part
Transverse clip following proximal tendon from proximal to distal
Transverse image proximal tendon/distal part with power Doppler
Transverse image proximal tendon/distal part with power Doppler
Transverse clip proximal tendon/distal part power Doppler
Longitudinal image proximal tendon and bursa
Longitudinal image proximal tendon and bursa

Conclusion

1. Tenosynovitis and effusion of the long head of the biceps tendon sheath. The tendon sheath also shows signs of neovascularization.
2. Subacromial/subdeltoid bursitis.

Details

  • Sex: Female
  • Age: 59
  • Body part: Shoulder