Biceps ultrasound: Correlation with tendinitis arthroscopy

Introduction To assess correlations between new sonographic features at different biceps tendon levels compared to tendinitis arthroscopy. Material and methods A total of 47 patients in our Upper Limb Orthopedic Surgery Department were prospectively included over a 5-month period. Arthroscopy was performed to assess the macroscopic appearance of the horizontal intra-articular portion of the tendon. The horizontal part of the biceps tendon was divided into 3 parts in order to assess inflammation by grade. The tendon was considered inflammatory in case of grade 2 and 3. Biceps tendon criteria were analyzed at five ultrasound levels, i.e. area, tendon flattening ratio, presence of fluid, Doppler inflammation assessment and intra-tendon ROI on a dynamic film to assess the maximum, minimum signal and heterogeneity. Results No significant correlations were found between arthroscopy-detected inflammation and the surface. On the dynamic film, the maximum tendon signal was significantly lower when the biceps tendon was classified by the surgeon as inflammatory ( p  = 0.030), and remained significant after logistic regression adjustment for age and gender ( p  = 0.048). The 114 threshold resulted in the best differentiation, with 91% sensitivity, 48% specificity, 86% NPV and 61% PPV. Discussion The maximum biceps tendon signal measured on a dynamic film made when tilting the probe was significantly lower when the tendon was detected as inflammatory via arthroscopy. None of the other quantitative or qualitative measurements had any correlation. Level of evidence IV.