Bone Scan Shoulder There is insufficient evidence to support the use of bone scan shoulder in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. CT Arthrography Shoulder Reports on the accuracy of CT arthrography for biceps tendinopathy are variable. Teixeira et al [118] reported a sensitivity of 74% to 79% and a specificity of 93% to 95% for tendinopathy as well as 100% sensitivity and 93% specificity for complete biceps ruptures. However, Rol et al [119] reported a correlation of only 45% to 65% with subsequent arthroscopy in a study consisting mostly of patients who underwent CT arthrography. CT arthrography diagnosis of biceps tendinopathy is primarily based off the change in tendon caliber. Chronic Shoulder Pain CT Shoulder With IV Contrast There is insufficient evidence to support the use of CT shoulder with IV contrast in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. CT Shoulder Without and With IV Contrast There is insufficient evidence to support the use of CT shoulder without and with IV contrast in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. CT Shoulder Without IV Contrast There is limited literature regarding the use of noncontrast CT to specifically evaluate the biceps tendon. In a small study, pooled sensitivity and specificity for proximal biceps lesions including degeneration, tendon subluxation, and tendon tear using CT were shown to be 31% and 95%, respectively [120]. FDG-PET/CT Skull Base to Mid-Thigh There is insufficient evidence to support the use of FDG-PET/CT skull base to mid-thigh in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Image-guided injection of the biceps tendon sheath using US guidance may be useful in patients with biceps pain for both diagnostic and therapeutic purposes [22].
Chronic Shoulder Pain PCAs. Bone Scan Shoulder There is insufficient evidence to support the use of bone scan shoulder in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. CT Arthrography Shoulder Reports on the accuracy of CT arthrography for biceps tendinopathy are variable. Teixeira et al [118] reported a sensitivity of 74% to 79% and a specificity of 93% to 95% for tendinopathy as well as 100% sensitivity and 93% specificity for complete biceps ruptures. However, Rol et al [119] reported a correlation of only 45% to 65% with subsequent arthroscopy in a study consisting mostly of patients who underwent CT arthrography. CT arthrography diagnosis of biceps tendinopathy is primarily based off the change in tendon caliber. Chronic Shoulder Pain CT Shoulder With IV Contrast There is insufficient evidence to support the use of CT shoulder with IV contrast in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. CT Shoulder Without and With IV Contrast There is insufficient evidence to support the use of CT shoulder without and with IV contrast in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. CT Shoulder Without IV Contrast There is limited literature regarding the use of noncontrast CT to specifically evaluate the biceps tendon. In a small study, pooled sensitivity and specificity for proximal biceps lesions including degeneration, tendon subluxation, and tendon tear using CT were shown to be 31% and 95%, respectively [120]. FDG-PET/CT Skull Base to Mid-Thigh There is insufficient evidence to support the use of FDG-PET/CT skull base to mid-thigh in the evaluation of chronic shoulder pain when biceps tendon abnormality is suspected. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Image-guided injection of the biceps tendon sheath using US guidance may be useful in patients with biceps pain for both diagnostic and therapeutic purposes [22].