Shoulder anatomy on ultrasound
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Biceps apparatus Long head of biceps tendon apparatus: transverse views of a normal biceps tendon above the bicipital groove (BCG) on the left and at the BCG on the right. The BCG is a vertical groove between the greater and lesser tuberosities of the humeral head. It is covered by the transverse humeral ligament (THL), which is essentially the coracohumeral ligament (CHL) at the BCG and holds the tendon in place. Superior to the BCG, the tendon is surrounded by the biceps pulley, which is formed from the CHL and superior glenohumeral ligament (SGL). The biceps pulley also holds the tendon in place. The subscapularis tendon inserts onto the lesser tuberosity adjacent to the BCG and pulley. Tearing of the subscapularis can disrupt the THL and/or the pulley leading to dislocation or varying degrees of subluxation of the biceps tendon out of the BCG. Dynamic assessment under ultrasound observation is crucial for establishing the integrity of the THL in the case of subluxation.
Images representing normal anatomy of the rotator cuff on ultrasound. More to follow.