Bicipital Tendonitis
Bicipital Tendonitis
It is an inflammation of the long head tendons and it is a
common cause of shoulder pain.
Usually associated with problems in the rotator cuff.
Most common in athletes
Dr Salameh Al dajah
Ortho 2014
Symptoms
Shoulder pain
Shoulder pain when lifting heavy objects
Shoulder pain when performing overhead activities
Tenderness over bicipital groove
Dr Salameh Al dajah
Ortho 2014
By physical examination:
Speed test: Patient complains
of anterior shoulder pain with
Diagnosis
flexion of the shoulder against resistance, while the elbow is
extended and the forearm is supinated.
Yergason test: The patient
complains of pain and
tenderness over the Bicipital
groove with forearm supination
against resistance with the
elbow flexed and the shoulder in
adduction. Popping of
subluxation of the tendon may
be demonstrated with this
maneuver.
Elbow Injuries
Elbow Fractures
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Olecranon fractures
Radius head fractures
Supracondyler fractures
Elbow dislocations
Tennis Elbow
Also known as lateral epicondylitis.
The incidence of LE is 1-2 % in general population.
Peak incidence occurring at 40-50 years of age .
In women aged 42-46 years incidence increases to
10%.
Up to 50% of all tennis players experience some type
of elbow pain, and 75–80% of these elbow complaints
are attributed to tennis elbow.
With tennis elbow, the common extensor tendon origin at
the Lateral epicondyle of the humerus is irritated, inflamed,
damaged and potentially torn.
The occurrence: Acute onset typically seen in young athletes.
 Chronic condition seen in older people.
Pathophysiology
Small tears in the tendon occur through overuse.
They begin to heal but when reinjured by continued use, the
tendons seem to finally give up on trying to heal
Then a condition called angiofibroblastic degeneration begins to
take over.
angiofibroblastic tendinosis tissue is a scar tissue that never
reaches maturity and remains weak and painful.
Causes
This injury is caused by repetitively twisting the wrist or •
forearm. The injury is classically associated with tennis
playing, hence the name "tennis elbow," but any activity that
involves repetitive twisting of the wrist (like using a
screwdriver) can lead to lateral epicondylitis.
Symptoms
Symptoms of LE are :Pain at the lateral elbow
Tenderness
Pain exaggerated on gripping or resisted wrist extension or
middle finger extension
Difficulty holding or gripping objects
Golfer's Elbow
It is also known as medial epicondylitis.
Similar to Tennis elbow (the common flexor tendon origin at
the medial epicondyle)
7-20x less common than LE
60% associated with Ulna neuropathy.
It is characterized by pain from the elbow to the wrist on the
palm side of the forearm.
The pain is caused by damage to the tendons that bend the
wrist toward the palm
Causes
Excessive force used to bend the wrist toward the palm,
such as swinging a golf club or pitching a baseball.
Other possible causes of medial epicondylitis include the
following:
weak shoulder and wrist muscles.
Symptoms
Pain along the palm side of the forearm, from the elbow to the wrist.
The pain can be felt when bending the wrist toward the palm against
resistance, or when squeezing a rubber ball.
However, each individual may experience symptoms differently.
Diagnosed of medial epicondylitis
The diagnosis of medial epicondylitis usually can be made
based on a physical examination.
The physician may rest the arm on a table, palm side up,
and ask the patient to raise the hand by bending the wrist
against resistance.
If a person has medial epicondylitis, pain usually is felt in
the elbow.
Carrying angle
carrying angle - the acute angle that is formed by the
longitudinal axis of the humerus and the longitudinal axis of
.the ulna
of valgus 25 -15 Female
Male 5-15 of valgus
cubitus valgus - carrying angle greater than 25
cubitus varus - carrying angle less than 5
(A) Cubitus varus; (B) cubitus valgus.
Hand and Wrist
• Collos’ fractures (ulnar and radius styloid
dorsal fracture)
• Smith fractures (Ulnar and radius styloid folar
fractures
• Scaphoid bone fractures
• Carpal bones fractures
• Metacarpal bones fractures
• Tendons ruptures (Malt finger)
• Carpal tunnel syndrome (median nerve
compression
• Ulnar nerve compression
• Thumb and fingers fractures
• Dequavarian tendonitis
Treatment
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After fracture healing use
Active exercise and ROM
Paraffin wax
For carpal tunnels and tennis/Golvers elbow
Ice and US may help
• Use FUTURA Splint on the wrist