Disorders of the distal biceps brachii tendon

Pathologic conditions of the distal biceps brachii tendon are of clinical interest, with partial and complete tears being the most common. However, the anatomy of the distal biceps brachii tendon makes imaging of the distal tendon somewhat difficult. An innovation in patient positioning for magnetic resonance (MR) imaging of the distal biceps tendon was recently described in which the patient lies prone with the arm overhead, the elbow flexed to 90, and the forearm supinated, so that the thumb points superiorly. The acronym FABS (flexed elbow, abducted shoulder, forearm supinated) has been used to describe this position. The FABS position creates tension in the tendon and minimizes its obliquity and rotation, resulting in a "true" longitudinal view of the tendon. MR imaging and, to a lesser extent, ultrasonography are useful in visualizing the distal tendon and in detecting other pathologic conditions in the cubital fossa. Partial tears are usually characterized by enlargement and abnormal contour of the tendon, along with abnormal intratendinous signal intensity. In complete tears, there is discontinuity and, if the bicipital aponeurosis is also disrupted, retraction. Imaging with FABS positioning can complement conventional MR imaging, especially in the axial plane, in the assessment of the distal biceps tendon. (c) RSNA, 2005.