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 (C)</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 (A)</p> Signup and view all the answers

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

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

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

<p>Ultrasound (C)</p> Signup and view all the answers

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

<p>Under 60 years old (C)</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 (A)</p> Signup and view all the answers

In what percentage of patients does primary biceps tendinitis occur?

<p>5% (B)</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 (C)</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 (A)</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 (A)</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' (C)</p> Signup and view all the answers

'Tendinosis' is described as a syndrome of:

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

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

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

What is the key indication of a positive Neer test?

<p>Pain referred to the bicipital groove (B)</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 (D)</p> Signup and view all the answers

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

<p>Neutral (D)</p> Signup and view all the answers

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

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

What is the defining action in the Speed test?

<p>Flexion of the shoulder against resistance (D)</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 (B)</p> Signup and view all the answers

Which test can be used to identify SLAP lesions?

<p>Anterior slide test (C)</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 (C)</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 (B)</p> Signup and view all the answers

What does a positive anterior slide test indicate?

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

How can injections help differentiate shoulder pain origins?

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

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

<p>Biceps tenodesis (D)</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 (D)</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 (D)</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 (B)</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 (C)</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 (B)</p> Signup and view all the answers

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

<p>MRI arthrography (D)</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 (B)</p> Signup and view all the answers

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

<p>MRI arthrography (A)</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 (C)</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 (D)</p> Signup and view all the answers

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

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

Why is ultrasonography considered challenging in obese patients?

<p>Difficulty in scanning due to patient size (A)</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 (B)</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 (C)</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 (A)</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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

<p>Yergason test (A)</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 (B)</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 (A)</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 (A)</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' (C)</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' (B)</p> Signup and view all the answers

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