Focal partial tears of the long head of the biceps brachii tendon at the entrance to the bicipital groove: MR imaging findings, surgical correlation, and clinical significance.

PURPOSE: The purpose of the study was to depict a subset of focal partial tears of the biceps brachii tendon, occurring at the entrance to the bicipital groove, which can be difficult to detect with MRI.

SUBJECTS AND METHODS: The institutional review board approved this HIPAA-compliant study; informed consent was waived. The authors retrospectively reviewed imaging and medical records in 16 consecutive patients (12 men, 4 women; mean age, 57 years) who had prospective MRI diagnoses of tendinopathy and/or partial tearing of the intra-articular segment of the long head of the biceps brachii tendon (LHBT) at the entrance to the bicipital groove (restricted to within 1 cm of the groove entrance) and who also had surgical correlation within 4 months of imaging.

RESULTS: Focal intrasubstance signal abnormality was noted in the tendons of 16 out of 16 (100%) patients. Focal tendon enlargement was noted in 8 out of 16 patients (50%). Fifteen out of 16 biceps partial tears (94%) were treated surgically. Shoulder pathology was restricted to the groove entrance in 4 out of 16 patients (25%).

CONCLUSIONS: We depict a subset of focal partial tears of the biceps tendon, which can be difficult to detect on MRI because of their anatomical location at the entrance to the bicipital groove. Although they may coexist with other causes of shoulder pain, these lesions can also occur in isolation. In either case, they are potential causes of pain that can be addressed surgically.