Biceps tendinitis: Difference between revisions
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Revision as of 00:26, 27 June 2016
Background
- Results from progressive impingement or isolated tendon injury
Clinical Features
- Pain
- Acute, intense, localized to anterior aspect of shoulder
- May occur at rest and be worse at night
Diagnosis
- Palpation of tendon w/in bicipital groove reproduces pain
- Forearm supination, especially against resistance, reproduces pain
- Yergason Test
- Flex patient's elbow to 90'
- Palpate bicipital groove as pt patient attempts forearm supination against resistance
- Pain/instability at prox bicipital groove indicates tendinitis or tendon subluxation
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Treatment
- Analgesia
- Relative rest
- Ice 10-15min TID
- Early mobilization w/ stretching exercises
Disposition
- Follow-up w/ PMD within 1wk