Ultrasound assessment in distal biceps tendon injuries: Techniques, pearls and pitfalls

Ultrasound assessment of the distal biceps tendon is challenging. The tendon has two components which are continuations of the long and short heads of the muscle, and these undergo 90 degrees of rotation along their course. The tendon has a deep insertion to the radial tuberosity. Therefore, a combination of approaches and examination techniques are utilized to ensure complete evaluation. The various ultrasound approaches used to assess the distal biceps tendon, with their advantages and limitations, will be described. Selected examples of distal biceps tendon injuries, with magnetic resonance imaging (MRI) correlation in challenging cases, will be demonstrated.