55 Questions
What is the main difference between biceps tendinitis and tendinosis?
Tendinitis is inflammation, while tendinosis is degeneration.
Which condition is most commonly accompanied by rotator cuff tears or SLAP lesions?
Biceps tendinitis
What is the typical complaint of patients with biceps tendinitis or tendinosis?
Deep, throbbing ache in the anterior shoulder
Which diagnostic imaging technique is preferred for visualizing the overall tendon?
Ultrasonography
What is the most common isolated clinical finding in biceps tendinitis?
Pain with arm in internal rotation
What may be both therapeutic and diagnostic for biceps tendinitis or tendinosis?
Corticosteroid injections
What is the most common isolated finding during physical examination of patients with biceps tendinitis?
Bicipital groove point tenderness
What is the best modality for evaluating isolated biceps tendinopathy extra-articularly?
Ultrasound
Which age group may undergo biceps tenodesis according to the text?
Under 60 years old
What is the primary cause of biceps tendinosis or tenosynovitis according to the text?
Bone spur formation of the acromion
In what percentage of patients does primary biceps tendinitis occur?
5%
What is the most common cause of primary impingement in athletes older than 35 years?
Bone spur formation of the acromion
What is the primary treatment recommendation if conservative measures fail after three months for biceps tendinitis?
Surgery
Which tendon around the long head of the biceps muscle is affected in biceps tendinitis?
'Long head' tendon
'Secondary impingement of the biceps tendon' can be caused by all of the following EXCEPT:
'Anterior capsule laxity'
'Tendinosis' is described as a syndrome of:
'Overuse and degeneration'
In the Yergason test, the patient is required to __________.
Supinate the forearm against resistance
What technique should be used to inject corticosteroid solution if a corticosteroid injection is required for biceps tendinitis?
Use a hemostat between the needle and skin
What is the key indication of a positive Neer test?
Pain referred to the bicipital groove
What is the key reason for not injecting directly into the biceps tendon while treating biceps tendinitis?
Risk of tendon rupture
During the Hawkins test, what position is the patient's forearm placed in?
Neutral
What are signs that may indicate infection after an injection for biceps tendinitis?
Redness (erythema)
What is the defining action in the Speed test?
Flexion of the shoulder against resistance
What radiologic evaluation should be done to diagnose biceps tendinitis or tendinosis after initial radiography of the shoulder?
Ultrasonography of the shoulder
Which test can be used to identify SLAP lesions?
Anterior slide test
Which corticosteroid has the highest common dosage range for tendon sheath injection for biceps tendinitis?
Triamcinolone acetonide
What should be done after injecting the corticosteroid solution for biceps tendinitis?
Withdraw the needle slowly to flush remaining solution
What does a positive anterior slide test indicate?
SLAP lesion
How can injections help differentiate shoulder pain origins?
By relieving pain with corticosteroid solutions
What is the recommended therapy if conservative measures fail after three months?
Biceps tenodesis
When is biceps tenotomy considered the procedure of choice?
For inactive patients 60 years and older with a ruptured biceps tendon
In what instances may biceps tenodesis be avoided?
For patients objecting to a muscle bulge above the elbow
What is the purpose of debridement in the context of biceps tendon tears?
To remove the ruptured biceps tendon from the glenohumeral joint
Under what circumstances should surgical removal of structures causing impingement be considered?
When structures are causing primary or secondary impingement
What is the purpose of a biceps tenotomy?
To remove the ruptured biceps tendon from the glenohumeral joint
What imaging study is preferable for diagnosing biceps lesions and SLAP lesions?
MRI arthrography
What is a disadvantage of invasive arthrography in filling the biceps tendon sheath?
Results in unreliable filling of the sheath
Which imaging study is known for being poorly correlated with arthroscopy?
MRI arthrography
What is a characteristic of MRI arthrography when evaluating partial tears of the biceps tendon?
Excellent detection compared to complete ruptures
Which imaging study shows only the bony origins of impingement syndrome and not soft tissue?
Radiography with anteroposterior views
What can be observed in the ALVIS view related to impingement syndrome?
Subacromial spur
Why is ultrasonography considered challenging in obese patients?
Difficulty in scanning due to patient size
What is the main advantage of ultrasound with a high frequency array transducer over MRI?
Better spatial resolution than MRI
In diagnosing biceps lesions, what does CT arthrography show that MRI arthrography might not?
Partial tears of the biceps tendon
What phase is involved in rehabilitation for an athlete's shoulder according to the text?
Stretching phase
What is the triangular area between the subscapularis and supraspinatus tendons known as?
Bicipital groove
Which shoulder structure is responsible for keeping the biceps tendon in its correct location?
Rotator interval
What condition may involve the biceps tendon due to its intra-articular location?
Rheumatoid arthritis
What is a common symptom experienced by patients with biceps tendinitis?
Pain that worsens at night
Which test is typically positive in cases where a SLAP lesion is suspected?
Yergason test
What physical position should a patient be in during an examination to specifically highlight biceps tendon injury?
Arm at side with 10 degrees of internal rotation
What finding is most commonly associated with biceps tendon injury during physical examination?
'Point tenderness' in the bicipital groove
In what position should the humeral head face during part of the physical examination for biceps tendon injury?
Forward
'Impingement underneath the coracoacromial arch' makes it challenging to rule out what concurrent condition during certain tests?
'Rotator cuff lesions'
'Pain secondary to impingement or tendinitis of the rotator cuff' can be challenging to distinguish from pain due to what condition?
'Biceps tendinitis'
Learn about the diagnosis and treatment of biceps tendinitis and tendinosis. Understand the differences between inflammation of the tendon and degeneration due to athletics or aging. Explore the management of these conditions.
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