REVIEW PAPER
The advances in diagnostic modalities of disorders of the long head of the biceps tendon – review
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1
Department of Histology and Embryology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
2
Department of Radiology, Multidisciplinary Hospital, Inowroclaw, Poland
3
Faculty of Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
Submission date: 2020-12-28
Final revision date: 2021-03-02
Acceptance date: 2021-03-08
Publication date: 2021-03-31
Medical Studies 2021;37(1):83-90
KEYWORDS
TOPICS
ABSTRACT
The broad spectrum of disorders of the long head of the biceps (LHBT) can be divided into 3 main categories: inflammatory reactions, degenerative conditions, and instability. More than 90% of patients with LHB tendinopathy have an additional shoulder pathology. Thus, a detailed radiological and histopathological evaluation is crucial for a complete and accurate diagnosis. The pathology of the LHBT starts from its ultrastructure with the alterations of both tenocytes and extracellular matrix. Furthermore, this is reflected in the light microscopy investigation, with marginal inflammatory response. The ultrasonography is useful in the detection of LHBT instability, hypoechogenic areas, increased tendon diameter, and dynamic examination of the tendon. A standard non-contrast magnetic resonance imaging (MRI) of the shoulder is a useful tool in the diagnostics of advance tendinopathy; however, it is essentially limited in the detection of partial tears. Based on current knowledge, ultrasound and MRI diagnostics modalities should be simultaneously used in the examination of LHBT disorders.
REFERENCES (49)
1.
Zabrzyński J, Gagat M, Paczesny Ł, Łapaj Ł, Grzanka D. Electron microscope study of the advanced tendinopathy process of the long head of the biceps brachii tendon treated arthroscopically. Folia Morphol (Warsz) 2018; 77: 371-377.
2.
Shishani Y, Streit J, Rodgers M, Gobezie R. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium. OAJSM 2015; 6: 63-70.
3.
Joseph M, Maresh CM, McCarthy MB, Kraemer WJ, Ledgard F, Arciero CL, Anderson JM, Nindl BC, Mazzocca AD. Histological and molecular analysis of the biceps tendon long head post-tenotomy. J Orthop Res 2009; 27: 1379-1385.
4.
Ditsios K, Agathangelidis F, Boutsiadis A, Karataglis D, Papadopoulos. Long head of the biceps pathology combined with rotator cuff tears. Adv Orthop 2012; 2012: 405472.
5.
Krupp RJ, Kevern MA, Gaines MD, Kotara S, Singleton SB. Long head of the biceps tendon pain: differential diagnosis and treatment. J Orthop Sports Phys Ther 2009; 39: 55-70.
6.
Ahrens PM, Boileau P. The long head of biceps and associated tendinopathy. J Bone Joint Surg Br 2007; 89-B: 1001-1009.
7.
Zappia M, Carfora M, Romano AM, Reginelli A, Brunese L, Rotondo A, Castagna A. Sonography of chondral print on humeral head. Skeletal Radiol 2016; 45: 35-40.
8.
Zabrzyński J, Paczesny Ł, Zabrzyńska A, Grzanka D, Łapaj Ł. Sonography in the instability of the long head of the biceps tendon confronted with histopathologic and arthroscopic findings. Folia Morphol (Warsz) 2018; 77: 583-590.
9.
Abate M, Silbernagel KG, Siljeholm C, Di Iorio A, De Amicis D, Salini V, Werner S, Paganelli R. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther 2009; 11: 235.
10.
Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med 1999; 27: 393-408.
11.
Wang JHC. Mechanobiology of tendon. J Biomech 2006; 39: 1563-1582.
12.
Sharma P, Maffulli N. Biology of tendon injury: healing, modeling and remodeling. J Musculoskelet Neuronal Interact 2006; 6: 181-190.
13.
Lavagnino M, Arnoczky SP. In vitro alterations in cytoskeletal tensional homeostasis control gene expression in tendon cells. J Orthop Res 2005; 23: 1211-1218.
14.
Ireland D, Harrall R, Curry V, Holloway G, Hackney R, Hazleman B, Riley G. Multiple changes in gene expression in chronic human Achilles tendinopathy. Matrix Biol 2001; 20: 159-169.
15.
Fu SC, Chan BP, Wang W, Pau HM, Chan KM, Rolf CG. Increased expression of matrix metalloproteinase 1 (MMP1) in 11 patients with patellar tendinosis. Acta Orthop Scand 2002; 73: 658-662.
16.
Alfredson H, Lorentzon M, Bäckman S, Bäckman A, Lerner UH. cDNA-arrays and real-time quantitative PCR techniques in the investigation of chronic Achilles tendinosis. J Orthop Res 2003; 21: 970-975.
17.
Nho SJ, Strauss EJ, Lenart BA, et al. Long Head of the biceps tendinopathy: diagnosis and management. J Am Acad Orthop Surg2010; 18: 645-656.
18.
Franchi M, Fini M, Quaranta M, De Pasquale V, Raspanti M, Giavaresi G, Ottani V, Ruggeri A. Crimp morphology in relaxed and stretched rat Achilles tendon. J Anat 2007; 210: 1-7.
19.
Maffulli N, Longo UG, Franceschi F, Rabitti C, Denaro V. Movin and bonar scores assess the same characteristics of tendon histology. Clin Orthop Relat Res 2008; 466: 1605-1611.
20.
Xu Y, Murrell GAC. The basic science of tendinopathy. Clin Orthop Relat Res 2008; 466: 1528-1538.
21.
Zabrzynski J, Gagat M, Paczesny L, Grzanka D, Huri G. Correlation between smoking and neovascularization in biceps tendinopathy – a functional preoperative and immunohistochemical study. Ther Adv Chronic Dis 2020; 11: 204062232095641.
22.
Zabrzyński J, Łapaj Ł, Paczesny Ł, Zabrzyńska A, Grzanka D. Tendon – function-related structure, simple healing process and mysterious ageing. Folia Morphol (Warsz) 2018; 77: 416-427.
23.
Lakemeier S, Schwuchow SA, Peterlein CD, Foelsch C, Fuchs-Winkelmann S, Archontidou-Aprin E, Paletta JRJ, Schofer MD. Expression of matrix metalloproteinases 1, 3, and 9 in degenerated long head biceps tendon in the presence of rotator cuff tears: an immunohistological study. BMC Musculoskelet Disord 2010; 11: 271.
24.
Glait SA, Mahure S, Loomis CA, Cammer M, Pham H, Feldman A, Jazrawi LM, Strauss EJ. Regional histologic differences in the long head of the biceps tendon following subpectoral biceps tenodesis in patients with rotator cuff tears and SLAP lesions. Knee Surg Sports Traumatol Arthrosc 2018; 26: 2481-2489.
25.
Mazzocca AD, McCarthy MBR, Ledgard FA, Chowaniec DM, McKinnon Jr WJ, Delaronde S, Rubino LJ, Apolostakos J, Romeo AA, Arciero RA, Beitzel K. Histomorphologic changes of the long head of the biceps tendon in common shoulder pathologies. Arthroscopy 2013; 29: 972-981.
26.
Zabrzyński J, Paczesny Ł, Łapaj Ł, Grzanka D, Szukalski J. Is the inflammation process absolutely absent in tendinopathy of the long head of the biceps tendon? Histopathologic study of the long head of the biceps tendon after arthroscopic treatment. Pol J Pathol 2017; 68: 318-325.
27.
Zabrzyński J, Paczesny Ł, Łapaj Ł, Grzanka D, Szukalski J. Process of neovascularisation compared with pain intensity in tendinopathy of the long head of the biceps brachii tendon associated with concomitant shoulder disorders, after arthroscopic treatment. Microscopic evaluation supported by immunohistochemical. Folia Morphol (Warsz) 2018; 77: 378-385.
28.
Fenwick SA, Hazleman BL, Riley GP. The vasculature and its role in the damaged and healing tendon. Arthritis Res 2002; 4: 252-260.
29.
Paynter KS. Disorders of the long head of the biceps tendon. Phys Med Rehabil Clin N Am 2004; 15: 511-528.
30.
Longo UG, Loppini M, Marineo G, Khan W, Maffulli N, Denaro V. Tendinopathy of the tendon of the long head of the biceps. Sports Med Arthrosc Rev 2011; 19: 321-332.
31.
Chen HS, Lin SH, Hsu YH, Chen SC, Kang JH. A comparison of physical examinations with musculoskeletal ultrasound in the diagnosis of biceps long head tendinitis. Ultrasound Med Biol 2011; 37: 1392-1398..
32.
Lewis JS, Raza SA, Pilcher J, Heron C, Poloniecki JD. The prevalence of neovascularity in patients clinically diagnosed with rotator cuff tendinopathy. BMC Musculoskelet Disord 2009; 10: 163.
33.
Armstrong A, Teefey SA, Wu T, Clark AM, Middleton WD, Yamaguchi K, Galatz LM. The efficacy of ultrasound in the diagnosis of long head of the biceps tendon pathology. J Shoulder Elbow Surg 2006; 15: 7-11.
34.
Le Corroller T, Cohen M, Aswad R, Pauly V, Champsaur P. Sonography of the painful shoulder: role of the operator’s experience. Skeletal Radiol 2008; 37: 979-986.
35.
Skendzel JG, Jacobson JA, Carpenter JE, Miller BS. Long head of biceps brachii tendon evaluation: accuracy of preoperative ultrasound. AJR Am J Roentgenol 2011; 197: 942-948.
36.
Ohberg L, Lorentzon R, Alfredson H. Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc 2001; 9: 233-238.
37.
Ptasznik R, Hennessy O. Abnormalities of the biceps tendon of the shoulder: sonographic findings. AJR Am J Roentgenol 1995; 164: 409-414.
38.
Huang SW, Wang WT. Quantitative diagnostic method for biceps long head tendinitis by using ultrasound. Sci World J 2013; 2013: 948323.
39.
Kao JT, Chiu CH, Hsu KY, Chang SS, Chan YS, Chen ACY. Biceps tendon instability with or without pulley tears: an arthroscopic diagnostic study. In Review 2020.
https://doi.org/10.21203/rs.2.....
40.
Ricci V, Özçakar L. Windshield wiper in the shoulder: ultrasound imaging for the proximal rotator cuff interval. Am J Phys Med Rehabil 2018:1.
https://doi.org/10.1097/000020....
41.
Gisslén K, Alfredson H. Neovascularisation and pain in jumper’s knee: a prospective clinical and sonographic study in elite junior volleyball players. Br J Sports Med 2005; 39: 423-428.
42.
Singh R, Singla M, Tubbs RS. Macro/micro observational studies of fibres maintaining the biceps brachii tendon in the bicipital groove: application to surgery, pathology and kinesiology. Folia Morphol (Warsz) 2015; 74: 439-446.
43.
Khazzam M, George MS, Churchill RS, Kuhn JE. Disorders of the long head of biceps tendon. J Shoulder Elbow Surg 2012; 21: 136-145.
44.
Carr RM, Shishani Y, Gobezie R. How accurate are we in detecting biceps tendinopathy? Clin Sports Med 2016; 35: 47-55.
45.
Buck FM, Grehn H, Hilbe M, Pfirrmann CWA, Manzanell S, Hodler J. Degeneration of the long biceps tendon: comparison of mri with gross anatomy and histology. Am J Roentgenol 2009; 193: 1367-1375.
46.
Lewis RB, Reyes BA, Khazzam MS. A review of recent advances in the diagnosis and treatment modalities for long head of bicep tendinopathy. Clinical Medicine Insights: Trauma and Intensive Medicine 2016; 7: CMTIM.S39404.
47.
Mohtadi NG, Vellet AD, Clark ML, Hollinshead RM, Sasyniuk TM, Fick GH, Burton PJ. A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain. J Shoulder Elbow Surg 2004; 13: 258-265.
48.
Dubrow S, Streit J, Shishani Y, Robbin MR, Gobezie R. Diagnostic accuracy in detecting tears in the proximal biceps tendon using standard nonenhancing shoulder MRI. OAJSM 2014; 5: 81-87.
49.
Zanetti M, Weishaupt D, Gerber C, Hodler J. Tendinopathy and rupture of the tendon of the long head of the biceps brachii muscle: evaluation with MR arthrography. Am J Roentgenol 1998; 170: 1557-1561.