Uber die bedeutung des halophanomens um die lange bizepssehne in der sonografie der schulter

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. Conclusion: A hypoechoic area around the long biceps tendon correlates with fluid in the synovial sheet and indicates effusion within the glenohumeral joint.