Biceps Tendonitis/ Tenosynovitis

Aetiology

Part of impingement syndrome with
- Rotator cuff tendonitis
- Subacromial bursitis

History

Pain in anterior shoulder
Worse with overhead motion
Pain at night especially lying on side

Examination

Tendon tender in groove
Anterior pain on ER
Speed's Test
- Shoulder flexed
- Elbow extended & forearm supinated
- Pain on resisted elevation
Yergason's Test
- Elbow 90°
- Pain with resisted supination

Investigations

XR
- Changes of impingement
- Bicipital groove shallow with medial & lateral osteophytes
Arthrography
- Narrowed attenuated tendon or vacuolation
- Elevation from floor by inflamed synovium
- Poor or no filling of sheath
Ultrasound
- Inflammation or attenuated tendon
- Fluid
MRI
- Narrowed attenuated tendon
- Increased signal intensity on T2
- Elevation of biceps from groove or origin by inflamed synovium

Treatment

Usually non-op
As for impingement
If fails then Tenodesis of tendon