The ultrasonographic appearance of biceps tendinitis

The argument about the use of ultrasound in musculoskeletal imaging is that is operator dependent. Studies show that the accuracy in diagnosis is affected by the experience of the sonographer. Although it has not replaced the use of MRI in the evaluation of the rotator cuff and labrum,  without a doubt the use of sonography is gaining ground in the evaluation of shoulder. We routinely use MSK ultrasound for the evaluation of shoulder problems because 1. It is a dynamic examination of the soft tissues 2. It is cheap 3. It is fast and can be done in the office 4. It improves the accuracy of cortizone injections.
The images below demonstrate fluid around the biceps tendon in the bicipital groove indicative of biceps tendinitis

Probe position

Prior to injection the biceps in the bicipital groove is surrounded by fluid (tendinitis)

Using sonographic guidance cortizone injection was given to the biceps tendon sheath showing the expansion of it