Rupture of the Tendon of the Long Head of the Biceps

In the place of its attachment to labrum glenoidale

Lesion, which can be connected with a damage of labrum glenoidale in this localization, is in the foreground of an interest. An important fact is that ruptures, which frequently affect the tendon of the long head of the biceps in this place, are parcial, and so these ruptures are mostly considered as tendinitis. On the other hand, probably tenovaginitis of the long head of the biceps, which is inducted by the rupture, are  very often main causes of patientís problems, so it means that also targetable therapy of this tenovaginitis (and in this case it is our belief that a local application of steroids is suitable) can bring a big relief. With regarding to the possibilities of present therapeutical methods the resolution of the rupture and tenovaginitis does not become only an academic question,  but a basic condition of the right therapeutical method.

 

In progress of a tendon distally from an attachment to labrum glenoidale right to muscular substance of m. biceps brachii (approximately from bicipital groove)

A long head of the biceps distally from the attachment to tuberculum scapulae superglenoidalis (from the upper edge of a proximal part of the bicipital groove) is already well accessible to the ultrasound examination. In this area the diagnosis is relatively clear in the case of localization of a rupture which goes through superficial fascia. At the complete rupture the bicipital groove stays empty, and the tendon is not found during the ultrasound examination at all. This rupture is very frequent ( see following picture). We have not met a complete rupture of this type for five years of outpatient department practice.

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picture of a complete rupture of the long head in progress of bicipital groove

 

Rupture of the Tendon of the Long Head of the Biceps in the muscle of biceps brachii                   

 

 

All the ruptures of m. biceps brachii were found only in the place of a passage of the tendon to the muscle, and they created a typical lump during flexion in the elbow, and they all were mostly parcial6.

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Device Examination of Ruptures of the Tendon of the Long Head of the Biceps

A determination of diagnosis especially of parcial anchored ruptures of the long head of the biceps belongs to difficult tasks in differential diagnostics of pains in the shoulder girdle7. If there is a suspicious that there is possible to carry out some of other examinations (except ultrasound) of these ruptures. This examination would eventually confirm the parcial anchored ruptures:

MRI

arthroscopy of the glenohumeral articulation

 

 

5i. e. arthroscopic suturas labrum glenoidale

6 at the ultrasound examination there was not any empty groove of the long head of the biceps

7 injury anamnesis is a base for the suspicion of the rupture, but unfortunately spontaneous ruptures are also very frequent