Zafer Güneş, Eralp Erdoğan, Cem Nuri Aktekin
Anatolian Current Medical Journal - 2025;7(6):855-860
Aims: The relationship between bicipital groove morphology and biceps tendon pathology remains controversial, and few studies have evaluated volumetric parameters. To investigate whether patients with biceps tendinitis have distinct morphometric and volumetric features of the bicipital groove compared with asymptomatic individuals. Methods: This retrospective study included 36 patients who underwent surgical treatment for biceps tendon pathology (tenodesis or tenotomy) and 66 asymptomatic controls with available shoulder MRI and CT scans. Exclusion criteria were prior shoulder surgery or fracture, labral lesions, adhesive capsulitis, inflammatory arthritis, advanced osteoarthritis, inadequate imaging quality, and prior corticosteroid injection. Radiological parameters included total opening angle (TOA), medial wall angle (MWA), groove width, groove depth, and groove volume measured on CT and MRI. Volumetric analysis was performed using OsiriX software. Inter- and intra- observer reliability was tested with intraclass correlation coefficients (ICCs). Results: Compared with controls, patients with biceps tendon pathology had significantly narrower groove width (10.26 vs 11.62 mm, p=0.010), greater depth (6.50 vs 5.52 mm, p=0.001), smaller TOA (75.73 derece vs 90.98 derece, p=0.001), larger MWA (51.23 derece vs 44.42 derece, p=0.001), and lower groove volumes on both CT (0.704 vs 0.918 mm³, p=0.001) and MRI (0.623 vs 0.794 mm³, p=0.001). No significant differences were found between tenodesis and tenotomy subgroups, or between male and female patients. ICC values indicated excellent inter- and intra-observer reliability (0.84-0.91). Conclusion: Patients with biceps tendinitis exhibit a narrower, deeper, and smaller bicipital groove compared to asymptomatic individuals, suggesting that groove morphology may represent a potential risk factor for tendon pathology. Volumetric analysis provides a novel and reliable tool for characterizing this anatomy. However, due to the limited sample size, group heterogeneity, and retrospective design, these results should be interpreted as preliminary and hypothesis-generating.
