Page 268 - Canine Lameness

240 15 Shoulder Region

(A) (B) (D)

(C)

SHOULDER REGION Figure 15.11 Biceps brachii palpation: (A) the biceps tendon can be digitally palpated, just medially to

the greater tubercle; (B) shoulder drawer test is performed by stabilizing the scapula with one hand,
while the other hand attempts to displace the humeral head cranially, relative to the supraglenoid
tubercle; (C) biceps disease can frequently be detected by eliciting a painful response when placing the
shoulder in flexion and hyperextending the elbow, while applying digital pressure to the biceps tendon,
the so-called biceps test; (D) a painful response during the biceps test may be due to elbow disease
since the elbow is hyperextended. This can easily be differentiated by performing isolated elbow
hyperextension.

humeral intertubercular groove and/or mineralization of the biceps tendon and osteophytosis can
be appreciated (Figure 15.12). Skyline views (Figure 15.13) may aid in identifying biceps pathology
in addition to distinguishing biceps disease from supraspinatus disease.
Contrast arthrography has been reported, but because of its invasive nature and due to the
increased use of ultrasound, this technique is less frequently performed. It may reveal incomplete
or narrowed contrast flow within the biceps tendon sheath, irregular biceps tendon definition, or
impingement of the biceps tendon (Davidson et al. 2000).
Ultrasound (Figure 10.2) is a useful tool to diagnose pathology of the biceps tendon, especially if
the ultrasonographer is skilled at musculoskeletal evaluation (Kramer et al. 2001; Barella et al.
2018). Ultrasound is the only imaging modality that can be performed in a dynamic fashion and