Medial displacement of the biceps brachii tendon: evaluation with dynamic sonography during maximal external shoulder rotation.

Abstract

To determine the value of the sonographic subluxation test--dynamic scanning of a shoulder during maximal external rotation--in the evaluation of medial displacement of the biceps tendon. The subluxation test was performed during shoulder sonography in 1,210 patients, 284 of whom subsequently underwent surgery (152 men and 132 women aged 24-77 years [mean, 52 years]). Subluxation or displacement of the biceps tendon was surgically confirmed in 21 of the 284 patients (16 men and five women aged 35-57 years [mean, 48 years]). The sonographic and surgical findings in these 21 patients were analyzed. The subluxation test helped detect 12 of 14 (86%) cases of subluxation. Static scanning (without the subluxation test) depicted six of seven (86%) cases of dislocation. The test failed or could not be performed in 18 of the 284 (6%) patients; however, no false-positive findings occurred. The subluxation test is reliable in the diagnosis of subluxation of the biceps tendon and should be performed during shoulder sonography.