A 40 yo female presented with left-sided neck and shoulder pain for 2 months after a fall. Pt is stable and neurologically intact. On exam, ROM of L shoulder limited. Xrays of the L shoulder were negative.
Bedside POCUS was done over the L anterior shoulder region showing:
In these views, we can see significant anechoic fluid surrounding an inhomogeneous-appearing long head of bicep tendon. These are ultrasonographic signs of biceps tendinitis.
The color doppler view here also shows increased vascularity in the tendon sheath due to inflammation:
Clinical Pearl: In biceps tendonitis, palpation of the tendon within the bicipital groove usually reproduces pain. Biceps tendonitis can be treated conservatively with NSAIDs, icing, and early mobilization with stretching exercises. In selected severe cases, patients may receive steroid injections into the bicep sheath/subacromial space outpatient.