Rotator Cuff
Recurrent Dislocation
Internal Impingement
ACJ SCJ
Neural Compression
Misc
Shoulder
Anatomy
Clinical
SASD Bursa
Supraspinatus
Partial Tears
Biceps Subscap
Calcification
Treatment
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Biceps


  • long head arises from the superior glenoid margin and the short head from the tip of the coracoid process
  • Long head has an intra-articular component
  • Axial imaging best for long head
  • Sling comprises coracohumeral and superior GH ligs


Biceps dislocation can occur either as a consequence of a tear of the rotator interval or a combined interval and subscapularis injury. Both of the structures should therefore be examined. Occasionally subluxation is incomplete and the biceps tendon can be seen perched on the medial margin of the groove, the lesser tuberosity.

If the groove is empty and the long head cannot be located medially, then rupture is likely. Careful examination of the more inferior positioned axial MR images or scanning more inferiorly with ultrasound will usually demonstrate the ruptured tendon end.
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Subcoracoid Impingement

  • arises from the undersurface of the scapula
  • multi-pennate muscle
  • tendon passes beneath the corocoid process and deep to the pectoralis
  • Contributes fibres to rotator sling and supraspinatus insertion


Tears of the supscapularis muscle and tendon are most commonly seen in association with advanced rotator cuff disease. Subscapularis tendinopathy is more common at the superior border of the tendon than the inferior. Subscapularis tendon tears may be associated with subluxation of the biceps tendon. If the tear involves the rotator interval only, the displaced biceps tendon will lie above the subscapular tendon which separates biceps from the underlying humerus. If there is a more significant injury, the biceps tendon becomes displaced from its groove and lies against the humeral head. An uncommon cause of subscapularis tendinopathy is impingement between a prominent coracoid process and the underlying humerus. In these patients, the corocoid process is usually elongated and the distance between its tip and the underlying humeral head is less than 9 mm
Subscapularis
Sub Coracoid Impingement
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