![]() ![]() An empty bicipital groove becomes filled with echogenic scar tissue that simulates a normal Long head of biceps tendon, although the characteristic fibrillar pattern of the tendon is not seen. In chronic rupture there is partial non-visualization of the upper portion of the tendon. Acute rupture results in non-visualization of the tendon within the bicipital groove and biceps muscle contraction with bulbous appearance/popeye sign. LT: Lesser tuberosityīiceps tendon can rupture in either an acute or chronic setting. Hypoechoic appearance (G) of biceps tendon with areas of increased Doppler signal as a result of tendinopathy. Long head of biceps tendon (arrows) in longitudinal (C) and transverse plane (E) appears hypoechoic (D and F) (arrows) due to anisotrophy when not imaged perpendicular to the sound beam. Probe placement to examine long head of the biceps tendon in transverse plane (A) and longitudinal plane (B). The author recommends following a systematic approach for scanning the shoulder. Some familiarity and understanding of the controls is an essential especially, if you are not the only one who uses the scanner. How much you adjust the machine controls and settings as you scan is very much a matter of taste. Tissue harmonic imaging can increase the conspicuity of tears, although, no difference in the diagnostic accuracy has been found. Lower for obese patient and higher for thin patient. Probe frequency selection depends on the patients build. The more the transducer frequency, which improves the resolution, the less is the depth penetration. ![]() Good-quality ultrasound equipment and a high-frequency (12-15 MHz) linear-array (with a flat surface) probe is required. Obtaining a brief history at the beginning of the examination can provide clues to the underlying pathology. The probe should be held at its end with the edge of the hand resting on the patient's shoulder, in order to reduce stress and allow fine motor control. The author prefers to scan standing behind the patient and recommends following a protocol that the user is comfortable with. There are various techniques for scanning the shoulder, some operators prefer to face the patient, and others prefer to stand behind, scanning over the patient's shoulder. ![]()
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