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Upper-edge subscapularis tendon tears associated with biceps instability are a cause of anterior shoulder pain and disability. At shoulder arthroscopy, the incidence of subscapularis pathology was noted to be 27%, with 47% of these being combined lesions involving the medial reflection pulley. The anatomic location of the upper subscapularis and biceps allows for combined fixation techniques.

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The shoulder joint houses a stabilizing structure called the biceps pulley. Biceps pulley lesions can trigger anterior shoulder pain and frequently coincide with rotator cuff tears, whose prevalence rises with age. In our study, we aim to assess the incidence of biceps pulley lesions associated with rotator cuff tears in patients undergoing arthroscopic repair, the possible associated factors, and whether MRI findings were correlated with them.

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Article Synopsis
  • Pathologies of the long head of the biceps tendon often lead to anterior shoulder pain, with anatomical variations in the intertubercular groove being a potential factor.
  • This study analyzed MRI scans of 35 patients to measure the relationship between the size of the biceps tendon and the groove it runs through, introducing the concept of a tendon-to-groove ratio.
  • Results showed a consistent reduction in this ratio at different points in the groove, but it did not significantly vary between patients with or without additional shoulder injuries like pulley or SLAP lesions.
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Introduction: Pathologies of the shoulder, i.e. rotator cuff tears and labral injuries are very common.

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Evaluation of Conventional MR Imaging of the Shoulder in the Diagnosis of Lesions of the Biceps Pulley.

Acad Radiol

August 2024

Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany; Musculoskeletal Radiology Section, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany.

Article Synopsis
  • The study aimed to evaluate the effectiveness and consistency of conventional MRI in diagnosing biceps pulley lesions, using arthroscopy for comparison.* -
  • Analyzing MRI results from 68 patients, the researchers found that MRI had high sensitivity (around 95%) and moderate specificity (about 61-80%) for identifying pulley lesions, with good agreement among radiologists.* -
  • The most reliable indicators included biceps tendinopathy and defects in specific ligaments, while subluxation/dislocation of the tendon was less reliable in sensitive detection but more specific.*
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