Contribution of MRI and CT arthrography to the diagnosis of intra-articular tendinopathy of the long head of the biceps - 23/10/14

Doi : 10.1016/j.otsr.2014.09.005

G. Nourissat ^a,^b,^⁎ , Q. Tribot-Laspiere ^c, F. Aim ^c, C. Radier ^d
^a Groupe Maussins, Clinique des Maussins, 67, rue de Romainville, 75019 Paris, France
^b UR4 Stress vieillissement inflammation, Université Pierre et Marie Curie, 75005 Paris, France
^c AP–HP, 75018 Paris, France
^d Service de Radiologie, Maunol, 67, rue de Romainville, 75019 Paris, France

^⁎Corresponding author. Groupe Maussins, Clinique des Maussins, 67, rue de Romainville, 75019 Paris, France.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 23 October 2014
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Abstract

Introduction

Clinical diagnosis of biceps tendinopathy is difficult to make because of the poor sensitivity of existing clinical tests. The goal of this study was to determine whether MRI or CT arthrogram could contribute to the diagnosis of tendinopathy in the intra-articular portion of the long head of biceps (LHB), while using macroscopic findings during shoulder arthroscopy as a reference.

Material and methods

A prospective, single-centre study was performed over a 4-month period. The radiology part of the study was carried out by a radiologist experienced in shoulder imaging. The arthroscopy part of the study was conducted while the biceps was being evaluated for treatment purposes. The study included 87 patients having an average age of 45.7years (range 17–78). Fifty-eight patients underwent CT arthrography and 38 underwent an MRI. Seven patients underwent both imaging exams. One patient was removed from the study because of a spontaneous LHB rupture. The demographics of the two study populations were equivalent.

Results

For the diagnosis of tendinopathy of the intra-articular portion of the long head of biceps, the CT arthrogram had a sensitivity of 71.43%, specificity of 100%, positive predictive value of 100% but a negative predictive value of 67.74%. For the diagnosis of tendinopathy of the intra-articular portion of the long head of biceps, the MRI had a sensitivity of 42.85%, specificity of 75%, positive predictive value of 50% but a negative predictive value of 69.23%.

Conclusion

This study showed that radiological diagnosis of tendinopathy of the long head of biceps remains challenging. Nevertheless, CT arthrography is more sensitive and specific than MRI in identifying this disorder.