Churgay Catherine A
St. Luke's Hospital/The University of Toledo, Family Medicine Residency Program, Toledo, Ohio 43614, USA.
Am Fam Physician. 2009 Sep 1;80(5):470-6.
Biceps tendinitis is inflammation of the tendon around the long head of the biceps muscle. Biceps tendinosis is caused by degeneration of the tendon from athletics requiring overhead motion or from the normal aging process. Inflammation of the biceps tendon in the bicipital groove, which is known as primary biceps tendinitis, occurs in 5 percent of patients with biceps tendinitis. Biceps tendinitis and tendinosis are commonly accompanied by rotator cuff tears or SLAP (superior labrum anterior to posterior) lesions. Patients with biceps tendinitis or tendinosis usually complain of a deep, throbbing ache in the anterior shoulder. Repetitive overhead motion of the arm initiates or exacerbates the symptoms. The most common isolated clinical finding in biceps tendinitis is bicipital groove point tenderness with the arm in 10 degrees of internal rotation. Local anesthetic injections into the biceps tendon sheath may be therapeutic and diagnostic. Ultrasonography is preferred for visualizing the overall tendon, whereas magnetic resonance imaging or computed tomography arthrography is preferred for visualizing the intra-articular tendon and related pathology. Conservative management of biceps tendinitis consists of rest, ice, oral analgesics, physical therapy, or corticosteroid injections into the biceps tendon sheath. Surgery should be considered if conservative measures fail after three months, or if there is severe damage to the biceps tendon.
肱二头肌肌腱炎是肱二头肌长头周围肌腱的炎症。肱二头肌肌腱病是由需要过头动作的体育运动或正常衰老过程导致的肌腱退变引起的。肱二头肌沟内的肱二头肌肌腱炎症，即原发性肱二头肌肌腱炎，在肱二头肌肌腱炎患者中占5%。肱二头肌肌腱炎和肌腱病通常伴有肩袖撕裂或SLAP（上盂唇从前到后）损伤。肱二头肌肌腱炎或肌腱病患者通常主诉肩部前方有深部搏动性疼痛。手臂反复进行过头动作会引发或加重症状。肱二头肌肌腱炎最常见的孤立临床体征是手臂内旋10度时肱二头肌沟处压痛。向肱二头肌腱鞘内注射局部麻醉剂可能具有治疗和诊断作用。超声检查更适合观察整个肌腱，而磁共振成像或计算机断层扫描关节造影更适合观察关节内肌腱及相关病变。肱二头肌肌腱炎的保守治疗包括休息、冰敷、口服镇痛药、物理治疗或向肱二头肌腱鞘内注射皮质类固醇。如果保守治疗三个月后失败，或者肱二头肌肌腱有严重损伤，则应考虑手术治疗。
