Can Quantification of Biceps Peritendinous Effusion Predict Rotator Cuff Pathologies?: A Retrospective Analysis of 1352 Shoulder Ultrasound

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The purposes of this study were to determine the best cutoff value for bicipital peritendinous effusion (BPE) and to test its diagnostic performance as regards shoulders with and without rotator cuff pathology.


We reviewed the sonographic reports of 1352 patients with suspected shoulder disorders between January 2011 and June 2012. The associations between BPE and rotator cuff abnormalities were explored by logistic regression and adjusted for age, sex, affected side, and clinical diagnosis of frozen shoulder. The receiver operating characteristic curves were constructed to assess the ability of BPE to discriminate certain rotator cuff pathologies. Maximal Youden indexes were used to define the best cutoff points, which were later applied on the validation data set for its discriminative ability.


Sonographic findings of subscapularis tendinopathy, subdeltoid bursitis, supraspinatus full-thickness tear, and supraspinatus articular-sided partial-thickness tear were found to be associated with BPE. The cutoff values of BPE to differentiate those lesions were 1.0, 0.9, 1.5, and 1.5 mm, respectively. Validation of the diagnostic performance of BPE at defined thicknesses yielded good negative predictive values for the aforementioned rotator cuff abnormalities.


Sonographically detected BPE seems to be in association with certain rotator cuff pathologies, and it can be utilized as an adjuvant finding to rule out such rotator cuff abnormalities.

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CME Objectives:

Upon completion of this article, the reader should be able (1) to realize the association between the biceps peritendinous effusion and other sonographic abnormal findings regarding the shoulder joint, (2) to understand the possible mechanism of biceps peritendinous effusion production, and (3) to use biceps peritendinous effusion as an adjuvant finding to rule out rotator cuff abnormalities.




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