Biceps Adhesion to the Rotator Cuff

The biceps has many conditions associated with it, ranging from instability, tendinitis, rupture, and superior labrum anterior posterior (SLAP) tears. Proximally about the shoulder, the long head of the biceps has been found to be a significant pain generator in conjunction with rotator cuff tears and glenohumeral osteoarthritis. Diagnoses of the biceps tendon are often difficult to identify clinically, and imaging is not as reliable as with other conditions within the shoulder. Additionally, anatomic variants of the intra-articular course of the long head of the biceps tendon have been described. Multiple articles describe the anatomy of the ‘‘sling’’ surrounding the long head of the biceps and its insertion at the glenoid and labrum, but relatively few discuss the anatomic variation as it traverses the intraarticular space. Recent literature is bringing this subject more to light and illustrating how the variations may play a role in pathologic entities. Dierickx et al described 12 variations of the intra-articular portion of the long head of the biceps tendon. Kim et al described a long head of the biceps tendon confluent with the intraarticular rotator cuff in a case report, which is similar to the case report presented here.