Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Bicipital tendonitisBiceps tendinitisBicep tenosynovitisBicipital tenosynovitisCalcific tendinitis ++ 726.12 Bicipital tenosynovitis ++ M75.20 Bicipital tendinitis, unspecified shoulder ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation1 +++ Description ++ Inflammation, irritation, swelling of the long head of biceps tendonOccurs most often from repetitive motion injuries or impingement syndrome, but can occur with sudden strain/stress to the tendon, or with rotator cuff tendonitis or pathologyEarly stages Tendon becomes swollen and redAs tendonitis develops, the tendon sheath may thickenLate stages Chronic inflammation may result in fraying of the tendonMay progress to rupture with long term inflammation Rupture will cause bulging, bruising, and gathering of the muscle (“Popeye” sign may indicate rupture) +++ Essentials of Diagnosis ++ History and clinical examLook for signs of pain with A/PROM, resistance, palpation, and specific tests for the bicep tendonPain with palpation of the bicipital groove with arm at 10 degrees of internal rotationPain with passive stretch of the bicep +++ General Considerations ++ History of repetitive motion, especially activities overheadCommon in swimming, tennis, baseball, and with occupational activities involving repetitive or overhead activity due to micro traumaCan be seen in individuals with other system-wide diseases such as rheumatoid arthritis or diabetesOften occurs secondary to impingement syndrome or rotator cuff injury +++ Demographics ++ Predominately individuals involved in repetitive activities in sports or work +++ Signs and Symptoms ++ Ache in the anterior medial or anterior lateral aspect of the shoulder Frequently worsens with overhead lifting or activityPain or ache with palpation at the bicipital groove that may travel down the anterior upper armOccasional snapping sound or sensation Full A/PROM, though pain may occur at the end ROMPain with resisted elbow-flexion or resisted forward-flexion of the shoulderPain with passive stretch of the bicep Positive special tests for the biceps +++ Functional Implications ++ Limited overhead activities, especially liftingLimited throwing and other rapid arm movements +++ Possible Contributing Causes ++ Frequent and prolonged overhead activity Prolonged repetitive use of the involved armPoor posture (rounded shoulders)Anteriorly displaced humeral headRotator cuff weaknessAgingSystemic diseases, such a rheumatoid arthritis or diabetes Previous bicipital injury +++ Differential Diagnosis ++ Rotator cuff tendonitisRotator cuff impingementRotator cuff tearSubacromial bursitisBicep tendinopathyBicep tearLabral tear +++ Imaging ++ Radiographs looking for calcification or boney abnormalitiesMRI ++ Radiographs may show calcification or other boney abnormalities of the shoulderMRI to evaluate soft tissue for structural changes or ruptureSwelling may be ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.