[Significance of the hypoechoic area around the long biceps tendon in shoulder sonography--underlying pathology].
OBJECTIVE
The objective was to evaluate the sonographic sign of a hypoechoic area ("halo-sign") around the long biceps tendon as an equivalent of intraarticular effusion.


METHODS
Part 1: Ten patients scheduled for shoulder arthroscopy underwent ultrasonography immediately before surgery. If there was no hypoechoic area around the long biceps tendon 30 ml of NaCl-solution (0.9%) were injected into the joint. After repetitive passive motion the patient underwent a second ultrasonography. Part 2: Ten consecutive patients with a hypoechoic area around the long biceps tendon underwent shoulder arthroscopy. During this procedure they were examined for intraarticular effusion. Patients with rheumatoid disease were excluded from the study.


RESULTS
Part 1: In 9 of 10 patients a hypoechoic area around the long biceps tendon was induced by injection into the joint. The area was 1.07 +/- 0.13 cm2. In one case we could not induce the described phenomenon. Part 2: In all patients with a hypoechoic area around the long biceps tendon an intraarticular effusion was found at arthroscopy.


CONCLUSIONS
A hypoechoic area around the long biceps tendon correlates with fluid in the synovial sheet and indicates effusion within the glenohumeral joint.
D001182:Arthroscopy; D005122:Exudates and Transudates / Q000000981:diagnostic imaging*; D006801:Humans; D012782:Shoulder / Q000000981:diagnostic imaging*; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D013582:Synovial Fluid / Q000378:metabolism; D013710:Tendons / Q000000981:diagnostic imaging*; D014463:Ultrasonography