Tendinopathy of the Distal Biceps Tendon is a Common Incidental Finding on Magnetic Resonance Imaging of the Elbow

Objectives: The prevalence of tendinopathic changes of the distal biceps tendon (DBT) is not clear, in both the general population and patients with symptoms that may be related to distal biceps tendinopathy. The purpose of this study is to retrospectively determine the prevalence of distal biceps tendinopathy in symptomatic and asymptomatic patients undergoing an MRI of the elbow. A secondary aim is to assess the association between age and the prevalence of incidental distal biceps tendinopathy.Methods: We assessed 1,180 MRI-reports describing the elbow region and calculated prevalence of incidental and symptomatic DBT tendinopathies. Symptomatic DBT tendinopathy was defined as patients that had complaints of anterior elbow pain. With a multivariate logistic regression analysis we tested whether age, sex, and race were independently associated with DBT tendinopathy.Results: 276 of 1,180 (23%) of the distal biceps tendons showed signal changes on the MRI. Only 114 (10%) showed DBT tendinopathy, of which60 (5% of all tendons, 53% of tendons with tendinopathy) were incidental. The prevalence peaked between 40-49.9 years (37%) and 50-59.9 years (30%). There was no significant association between increasing age and incidental DBT tendinopathy (P= 0.935). However, there was a significant association between increasing age and tendinopathy, whether the tendinopathy was incidental or symptomatic (P 0.001).Conclusion: Signal changes in the DBT are common on MRI scans, however 53% of detected tendinopathies are incidental. There is no association between increasing age and prevalence of incidental DBT tendinopathy, though there is a significant association between increasing age and DBT tendinopathy. Level of evidence: II