Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA.
J Ultrasound Med. 2019 Dec;38(12):3267-3271. doi: 10.1002/jum.15062. Epub 2019 Jun 11.
To determine the frequency of ultrasound (US) appearances of the extra-articular long head of the proximal biceps tendon in patients referred for US-guided biceps tendon sheath injections.
We reviewed our US-guided biceps tendon sheath injections between January 2015 and December 2017, noting the appearance of the biceps tendon and sheath, as well as the needle size used, and what was injected. Clinical electronic medical records were also reviewed to determine safety and patients' responses.
A total of 300 US-guided biceps tendon sheath injections were performed for anterior shoulder pain. Preliminary US evaluations revealed that 129 of 300 (43%) patients had a normal US appearance of the biceps tendon; 110 (36.6%) had tendinosis; 13 (4.3%) had tenosynovitis; 31 (10.3%) had both tendinosis and tenosynovitis; 8 (2.7%) had a biceps tendon tear; and 9 (3%) had a history of a tenodesis. Of 81 patients who had pain relief after the injection, 41 had a normal tendon appearance on US, and 40 had an abnormal US appearance.
A large minority of patients with anterior shoulder pain clinically suspected to be due to the biceps tendon have a normal-appearing tendon and sheath. This should not dissuade the operator from performing the procedure.
确定接受超声引导肱二头肌腱鞘注射的患者中，肱二头肌长头肌腱关节外部分的超声表现的频率。
我们回顾了 2015 年 1 月至 2017 年 12 月期间进行的超声引导肱二头肌腱鞘注射，记录了肱二头肌和腱鞘的外观、所用的针的大小以及注射的内容物。还查阅了临床电子病历，以确定安全性和患者的反应。
共对 300 例有肩部前方疼痛的患者进行了超声引导肱二头肌腱鞘注射。初步超声评估显示，300 例患者中有 129 例（43%）的肱二头肌肌腱超声外观正常；110 例（36.6%）有肌腱变性；13 例（4.3%）有腱鞘炎；31 例（10.3%）既有肌腱变性又有腱鞘炎；8 例（2.7%）有肱二头肌肌腱撕裂；9 例（3%）有肌腱切断术史。在接受注射后疼痛缓解的 81 例患者中，41 例的超声显示肌腱外观正常，40 例的超声显示肌腱外观异常。
临床上怀疑肩部前方疼痛是由肱二头肌引起的患者中，少数人有正常外观的肌腱和腱鞘。这不应阻止操作者进行该操作。
