Biceps Tenosynovitis

Home
About Us
- - About Us
  - About AMSSM
  - FAMSSM Designation
  - Awards
  - Founders
  - Past Presidents
  - Board of Directors
  - Committees
  - Contact Us
  - Bylaws/Policy & Committee Handbooks
- - FAMSSM Applications
  - Application submission is now closed for the 2026 Class of AMSSM Fellows. New Fellows will be announced to the AMSSM membership after the first of the year and honored at the 2026 Annual Meeting.
    
    Applications for the FAMSSM Designation will be available on an annual basis. Please contact Ellen Glasgow with any questions regarding the FAMSSM application.
- - We Understand You

Communications
- - Communications
  - Collaborate.AMSSM.org
  - New Branding Campaign
  - AMSSM Member Marketing Toolkit
  - Journal Access
  - Publications/Position Statements
  - Press Releases
  - Brochures
  - Weekly Digests
- - Online AMSSM Community for Members
  - AMSSM Collaborate online community provides a forum for year-long connection, giving members the chance to have conversations, share resources and make connections with your peers.
- - AMSSM Informational Brochures
  - Find informational brochures about sports medicine physicians geared toward coaches, parents and other healthcare professionals.
Education
- - AMSSM Sports Medcasts
  - Find all current and past AMSSM Sports Medcast episodes in one convenient location.
- - AMSSM Fellow Online Lecture Series
  - The AMSSM National Fellow Online Lecture Series features talks from national experts on fundamental sports medicine topics pertinent to fellowship training and sports medicine board certification. Go to the collaborate.amssm.org site and view the available lectures in the Upcoming Events area.
Research
Advocacy
- - Legislative and Policy Issues
  - AMSSM is the go-to organization for legislative and policy issues related to sports medicine and athlete health and safety.
- - Legislation by State
  - AMSSM offers a variety of advocacy resources, including a map that tracks legislation important to sports medicine physicians.
Sports US
- - Sports Ultrasound Online Didactics
  - These 35 educational modules cover all of the didactic instructional session topics recommended for sports medicine fellows by the AMSSM.
- - Sports Ultrasound Committee
  - Find all the resources, materials and guidelines from the AMSSM Sports Ultrasound Committee
Patients
- - Need a Sports Medicine Physician?
  - FindADoc
- - SportsMedToday.com
  - Your comprehensive sports medicine resource for athletes, coaches and parents.
Additional Information
- - Additional Information
  - Sports Med Today
  - Journals
  - Weekly Digests
  - Store
  - Careers
  - Industry
Foundation

Biceps Tenosynovitis

Authors, Editors, Case Information Author: Cameron Taylor, DO Affiliation: Inspira Physical Medicine & Rehabilitation Residency/Rowan-Virtua School of Osteopathic Medicine Co Author(s): Altamash Raja, DO, RMSK, CSCS Senior Editor: Drew Duerson, MD Clinical Vignette: A 73-year-old female presented with chronic right shoulder pain that had been worse over the prior month. Pain was located along the anterior shoulder and radiated down the arm. She woke up with bruising one week prior with no known trauma, pop, or injury that self-resolved in a couple days. She denied new weakness, numbness, tingling. Pain was worse with cooking and lifting objects overhead. Type of Probe Used: Linear transducer 15-4 MHz Unlabeled Short Axis View of the Biceps Long Head Tendon Unlabeled Short Axis View of the Biceps Long Head Tendon Unlabeled Short Axis View of the Biceps Long Head Tendon with Doppler Unlabeled Short Axis View of the Biceps Long Head Tendon with Doppler showing evidence of surrounding hyperemia. Labeled Short Axis View of the Biceps Long Head Tendon Labeled short axis view of the proximal long head of the biceps tendon at the bicipital groove. Notice the anechoic fluid surrounding the biceps tendon within the sheath. This was compressible with transducer pressure and recreated pain upon sonopalpation. Unlabeled Long Axis View of the Biceps Long Head Tendon Unlabeled Long Axis View of the Biceps Long Head Tendon Unlabeled Long Axis View of the Biceps Long Head Tendon with Doppler Unlabeled Long Axis View of the Biceps Long Head Tendon with power doppler showing evidence of surrounding hyperemia. Labeled Long Axis View of the Biceps Long Head Tendon Labeled long axis view of the proximal long head of the biceps tendon at the bicipital groove. Notice the anechoic fluid along the biceps tendon within the sheath. This was compressible with transducer pressure and recreated pain upon sonopalpation. #7 - Video View Video Short axis cine of long head of biceps from proximal to distal with anechoic fluid surrounding the biceps tendon within the sheath. #8 - Video View Video Long axis cine of long head of biceps at bicipital groove. Transducer is tilted medially and laterally and then slid distally with anechoic fluid surrounding the biceps tendon within the sheath. #9 - Video View Video Short axis cine of long head of biceps at bicipital groove. Elbow at 90 degrees of flexion. Shoulder at 0 degrees of flexion/extension. Arm brought actively by patient from neutral into 15-20 degrees external rotation and then internally rotated back to neutral. No subluxation noted. Interpretation Image Interpretation: The biceps tendon is intact with normal fibrillar echotexture and thickness. An anechoic fluid collection is noted within the tendon sheath with isoechoic synovial thickening and marked hyperemia suggestive of bicipital tenosynovitis. No biceps tendon subluxation noted on dynamic evaluation. Teaching Pearl: Ultrasound is one accurate and accessible tool for evaluating the extra-articular long head of the biceps tendon. Biceps tenosynovitis appears as tendon sheath fluid, synovial hypertrophy, and Doppler hyperemia, while the tendon itself may remain intact. Because the biceps tendon sheath communicates with the glenohumeral joint, sheath fluid may reflect intra-articular pathology rather than isolated tendon disease. The scan should also assess biceps stability, subscapularis integrity, supraspinatus pathology, and the rotator interval. References: 1. Ostrowski JL, Beaumont A, Dochterman E. Diagnostic accuracy of musculoskeletal ultrasound on long head biceps tendon pathologies. J Sport Rehabil. 2021;30(7):1098-1101. doi:10.1123/jsr.2020-0511 2. Armstrong A, Teefey SA, Wu T, et al. The efficacy of ultrasound in the diagnosis of long head of the biceps tendon pathology. J Shoulder Elbow Surg. 2006;15(1):7-11. doi:10.1016/j.jse.2005.04.008 3. Park I, Lee HJ, Kim SE, et al. Evaluation of the effusion within biceps long head tendon sheath using ultrasonography. Clin Orthop Surg. 2015;7(3):351-358. doi:10.4055/cios.2015.7.3.351
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

Back		Top

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek

Authors, Editors, Case Information

Unlabeled Short Axis View of the Biceps Long Head Tendon

Unlabeled Short Axis View of the Biceps Long Head Tendon with Doppler

Labeled Short Axis View of the Biceps Long Head Tendon

Unlabeled Long Axis View of the Biceps Long Head Tendon

Unlabeled Long Axis View of the Biceps Long Head Tendon with Doppler

Labeled Long Axis View of the Biceps Long Head Tendon

#7 - Video

#8 - Video

#9 - Video

Interpretation

UPCOMING EVENTS

FIND A SPORTS DOC