Quantitative Diagnostic Method for Biceps Long Head Tendinitis by Using Ultrasound

Objective. To investigate the feasibility of grayscale quantitative diagnostic method for biceps tendinitis and determine the cut-off points of a quantitative biceps ultrasound (US) method to diagnose biceps tendinitis. Design. Prospective cross-sectional case controlled study. Setting. Outpatient rehabilitation service. Methods. A total of 336 shoulder pain patients with suspected biceps tendinitis were recruited in this prospective observational study. The grayscale pixel data of the range of interest (ROI) were obtained for both the transverse and longitudinal views of the biceps US. Results. A total of 136 patients were classified with biceps tendinitis, and 200 patients were classified as not having biceps tendinitis based on the diagnostic criteria. Based on the Youden index, the cut-off points were determined as 26.85 for the transverse view and 21.25 for the longitudinal view of the standard deviation (StdDev) of the ROI values, respectively. When the ROI evaluation of the US surpassed the cut-off point, the sensitivity was 68% and the specificity was 90% in the StdDev of the transverse view, and the sensitivity was 81% and the specificity was 73% in the StdDev of the longitudinal view to diagnose biceps tendinitis. Conclusion. For equivocal cases or inexperienced sonographers, our study provides a more objective method for diagnosing biceps tendinitis in shoulder pain patients.

[1]  Wen-Chung Tsai,et al.  The effects of aging on quantitative sonographic features of rotator cuff tendons , 2012, Journal of clinical ultrasound : JCU.

[2]  Shih-Ching Chen,et al.  A comparison of physical examinations with musculoskeletal ultrasound in the diagnosis of biceps long head tendinitis. , 2011, Ultrasound in medicine & biology.

[3]  M. Provencher,et al.  Long Head of the Biceps Tendinopathy: Diagnosis and Management , 2010, The Journal of the American Academy of Orthopaedic Surgeons.

[4]  C. A. Churgay Diagnosis and treatment of biceps tendinitis and tendinosis. , 2009, American family physician.

[5]  A. Iagnocco,et al.  Reliability of ultrasonography in detecting shoulder disease in patients with rheumatoid arthritis , 2008, Annals of the rheumatic diseases.

[6]  P. Champsaur,et al.  Sonography of the painful shoulder: role of the operator’s experience , 2008, Skeletal Radiology.

[7]  Cheol Min Park,et al.  Usefulness of standard deviation on the histogram of ultrasound as a quantitative value for hepatic parenchymal echo texture; preliminary study. , 2006, Ultrasound in medicine & biology.

[8]  B. Jensen,et al.  Quantitative ultrasound tissue characterization in shoulder and thigh muscles – a new approach , 2006, BMC musculoskeletal disorders.

[9]  Z. R. Yorgancıoğlu,et al.  Shoulder Impingement Syndrome: Relationships Between Clinical, Functional, and Radiologic Findings , 2006, American journal of physical medicine & rehabilitation.

[10]  P. O'connor,et al.  Interobserver variation in sonography of the painful shoulder , 2005, Journal of clinical ultrasound : JCU.

[11]  F. Kainberger,et al.  Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study. , 2004, European journal of radiology.

[12]  Markku Nurminen,et al.  Liver echogenicity: measurement or visual grading? , 2004, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[13]  Michael F Insana,et al.  On the ultrasonic properties of tendon. , 2003, Ultrasound in medicine & biology.

[14]  D. Cosgrove,et al.  Advances in ultrasound. , 2002, Clinical radiology.

[15]  G. McCluskey,et al.  Biceps tendinitis and subluxation. , 2001, Clinics in sports medicine.

[16]  A. Murthi,et al.  The incidence of pathologic changes of the long head of the biceps tendon. , 2000, Journal of shoulder and elbow surgery.

[17]  W. Grassi,et al.  Sonographic imaging of tendons. , 2000, Arthritis and rheumatism.

[18]  F Stacul,et al.  Ultrasonography and PACS. , 1998, European journal of radiology.

[19]  L. Bigliani,et al.  Special considerations in the athletic throwing shoulder. , 1997, The Orthopedic clinics of North America.

[20]  E. Craig,et al.  Ultrasonography of rotator cuff tears: A review of 500 diagnostic studies , 1988, Journal of clinical ultrasound : JCU.

[21]  F. Hall,et al.  Ultrasonographic evaluation of the rotator cuff and biceps tendon. , 1986, The Journal of bone and joint surgery. American volume.

[22]  V. Mayer Ultrasonography of the rotator cuff. , 1985, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.