Diagnosis and Treatment of Biceps Tendinitis and Tendinosis
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Questions and Answers

What is the main difference between biceps tendinitis and tendinosis?

  • Tendinitis is inflammation, while tendinosis is degeneration. (correct)
  • Tendinitis is caused by athletics, while tendinosis is caused by aging.
  • Tendinitis causes superficial pain, while tendinosis causes deep ache.
  • Tendinitis occurs in the bicipital groove, while tendinosis occurs in the tendon sheath.
  • Which condition is most commonly accompanied by rotator cuff tears or SLAP lesions?

  • Biceps tendinitis (correct)
  • Shoulder dislocation
  • Biceps tendinosis
  • Frozen shoulder
  • What is the typical complaint of patients with biceps tendinitis or tendinosis?

  • Pain in both shoulders simultaneously
  • Deep, throbbing ache in the anterior shoulder (correct)
  • Numbness and tingling in the arm
  • Sharp pain in the posterior shoulder
  • Which diagnostic imaging technique is preferred for visualizing the overall tendon?

    <p>Ultrasonography</p> Signup and view all the answers

    What is the most common isolated clinical finding in biceps tendinitis?

    <p>Pain with arm in internal rotation</p> Signup and view all the answers

    What may be both therapeutic and diagnostic for biceps tendinitis or tendinosis?

    <p>Corticosteroid injections</p> Signup and view all the answers

    What is the most common isolated finding during physical examination of patients with biceps tendinitis?

    <p>Bicipital groove point tenderness</p> Signup and view all the answers

    What is the best modality for evaluating isolated biceps tendinopathy extra-articularly?

    <p>Ultrasound</p> Signup and view all the answers

    Which age group may undergo biceps tenodesis according to the text?

    <p>Under 60 years old</p> Signup and view all the answers

    What is the primary cause of biceps tendinosis or tenosynovitis according to the text?

    <p>Bone spur formation of the acromion</p> Signup and view all the answers

    In what percentage of patients does primary biceps tendinitis occur?

    <p>5%</p> Signup and view all the answers

    What is the most common cause of primary impingement in athletes older than 35 years?

    <p>Bone spur formation of the acromion</p> Signup and view all the answers

    What is the primary treatment recommendation if conservative measures fail after three months for biceps tendinitis?

    <p>Surgery</p> Signup and view all the answers

    Which tendon around the long head of the biceps muscle is affected in biceps tendinitis?

    <p>'Long head' tendon</p> Signup and view all the answers

    'Secondary impingement of the biceps tendon' can be caused by all of the following EXCEPT:

    <p>'Anterior capsule laxity'</p> Signup and view all the answers

    'Tendinosis' is described as a syndrome of:

    <p>'Overuse and degeneration'</p> Signup and view all the answers

    In the Yergason test, the patient is required to __________.

    <p>Supinate the forearm against resistance</p> Signup and view all the answers

    What technique should be used to inject corticosteroid solution if a corticosteroid injection is required for biceps tendinitis?

    <p>Use a hemostat between the needle and skin</p> Signup and view all the answers

    What is the key indication of a positive Neer test?

    <p>Pain referred to the bicipital groove</p> Signup and view all the answers

    What is the key reason for not injecting directly into the biceps tendon while treating biceps tendinitis?

    <p>Risk of tendon rupture</p> Signup and view all the answers

    During the Hawkins test, what position is the patient's forearm placed in?

    <p>Neutral</p> Signup and view all the answers

    What are signs that may indicate infection after an injection for biceps tendinitis?

    <p>Redness (erythema)</p> Signup and view all the answers

    What is the defining action in the Speed test?

    <p>Flexion of the shoulder against resistance</p> Signup and view all the answers

    What radiologic evaluation should be done to diagnose biceps tendinitis or tendinosis after initial radiography of the shoulder?

    <p>Ultrasonography of the shoulder</p> Signup and view all the answers

    Which test can be used to identify SLAP lesions?

    <p>Anterior slide test</p> Signup and view all the answers

    Which corticosteroid has the highest common dosage range for tendon sheath injection for biceps tendinitis?

    <p>Triamcinolone acetonide</p> Signup and view all the answers

    What should be done after injecting the corticosteroid solution for biceps tendinitis?

    <p>Withdraw the needle slowly to flush remaining solution</p> Signup and view all the answers

    What does a positive anterior slide test indicate?

    <p>SLAP lesion</p> Signup and view all the answers

    How can injections help differentiate shoulder pain origins?

    <p>By relieving pain with corticosteroid solutions</p> Signup and view all the answers

    What is the recommended therapy if conservative measures fail after three months?

    <p>Biceps tenodesis</p> Signup and view all the answers

    When is biceps tenotomy considered the procedure of choice?

    <p>For inactive patients 60 years and older with a ruptured biceps tendon</p> Signup and view all the answers

    In what instances may biceps tenodesis be avoided?

    <p>For patients objecting to a muscle bulge above the elbow</p> Signup and view all the answers

    What is the purpose of debridement in the context of biceps tendon tears?

    <p>To remove the ruptured biceps tendon from the glenohumeral joint</p> Signup and view all the answers

    Under what circumstances should surgical removal of structures causing impingement be considered?

    <p>When structures are causing primary or secondary impingement</p> Signup and view all the answers

    What is the purpose of a biceps tenotomy?

    <p>To remove the ruptured biceps tendon from the glenohumeral joint</p> Signup and view all the answers

    What imaging study is preferable for diagnosing biceps lesions and SLAP lesions?

    <p>MRI arthrography</p> Signup and view all the answers

    What is a disadvantage of invasive arthrography in filling the biceps tendon sheath?

    <p>Results in unreliable filling of the sheath</p> Signup and view all the answers

    Which imaging study is known for being poorly correlated with arthroscopy?

    <p>MRI arthrography</p> Signup and view all the answers

    What is a characteristic of MRI arthrography when evaluating partial tears of the biceps tendon?

    <p>Excellent detection compared to complete ruptures</p> Signup and view all the answers

    Which imaging study shows only the bony origins of impingement syndrome and not soft tissue?

    <p>Radiography with anteroposterior views</p> Signup and view all the answers

    What can be observed in the ALVIS view related to impingement syndrome?

    <p>Subacromial spur</p> Signup and view all the answers

    Why is ultrasonography considered challenging in obese patients?

    <p>Difficulty in scanning due to patient size</p> Signup and view all the answers

    What is the main advantage of ultrasound with a high frequency array transducer over MRI?

    <p>Better spatial resolution than MRI</p> Signup and view all the answers

    In diagnosing biceps lesions, what does CT arthrography show that MRI arthrography might not?

    <p>Partial tears of the biceps tendon</p> Signup and view all the answers

    What phase is involved in rehabilitation for an athlete's shoulder according to the text?

    <p>Stretching phase</p> Signup and view all the answers

    What is the triangular area between the subscapularis and supraspinatus tendons known as?

    <p>Bicipital groove</p> Signup and view all the answers

    Which shoulder structure is responsible for keeping the biceps tendon in its correct location?

    <p>Rotator interval</p> Signup and view all the answers

    What condition may involve the biceps tendon due to its intra-articular location?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is a common symptom experienced by patients with biceps tendinitis?

    <p>Pain that worsens at night</p> Signup and view all the answers

    Which test is typically positive in cases where a SLAP lesion is suspected?

    <p>Yergason test</p> Signup and view all the answers

    What physical position should a patient be in during an examination to specifically highlight biceps tendon injury?

    <p>Arm at side with 10 degrees of internal rotation</p> Signup and view all the answers

    What finding is most commonly associated with biceps tendon injury during physical examination?

    <p>'Point tenderness' in the bicipital groove</p> Signup and view all the answers

    In what position should the humeral head face during part of the physical examination for biceps tendon injury?

    <p>Forward</p> Signup and view all the answers

    'Impingement underneath the coracoacromial arch' makes it challenging to rule out what concurrent condition during certain tests?

    <p>'Rotator cuff lesions'</p> Signup and view all the answers

    'Pain secondary to impingement or tendinitis of the rotator cuff' can be challenging to distinguish from pain due to what condition?

    <p>'Biceps tendinitis'</p> Signup and view all the answers

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