"Mick Jagger" Position Helps Improve Visualization of Biceps Tendon on Ultrasound

By Paul LaTour

Proper position of the shoulder in internal rotation combined with various degrees of abduction, traction and contraction of the biceps, improves the visualization of the intra-articular portion of the biceps brachii tendon on ultrasound, according to an education exhibit available for viewing at RSNA 2014.

The new maneuver—called the "Mick Jagger position" for its resemblance to a common mannerism used by the Rolling Stones lead singer—can be useful in detecting biceps intra-articular tendinosis, synovitis and biceps degeneration, Patrick Omoumi, M.D., said in an interview prior to the annual meeting.

"I considered the anatomy with the tendon moving as the shoulder is put in different positions, and the Mick Jagger position is the one where it is the best visible," said Dr. Omoumi, associate physician at Service de Radiologie Diagnostique et Interventionnelle in Lausanne, Switzerland.

To position the shoulder for proper visualization in the Jagger version, internal rotation is followed by different degrees of abduction followed by biceps contraction. Traction of the arm is the final motion.

In a classical position, a shoulder ultrasound is limited because of the tendon's location deep in the body and behind bones. Anistropy artifacts and clavicular acoustic shadow prevent proper visualization of the fibrillarpattern.

"You need to have techniques to put those tendons in movement and to be able to visualize them despite the difficulties due to the location and the trajectory, which is actually curved," Dr. Omoumi said. "You cannot assess the deepest portion of it. You can by using MR imaging, but that doesn't allow you to see joints and movement, which ultrasound does."

The researchers performed a cadaveric study to demonstrate the anatomy of the intra-articular portion of the biceps tendon, as well as its relations with the surrounding structures.

Clinically, the maneuver can help in the discovery and treatment of common shoulder pain, Omoumi said. "One of the reasons people tend to get shoulder pain is tendinosis of this biceps tendon," Dr. Omoumi said. "The tendon is a frequent cause of pain and is not easily visualized with a conventional technique."

See Education Exhibit MKE246 in the Learning Center, today through Thursday 7:00 a.m – 7:30 p.m. and Friday 7:00 a.m.– 12:30 p.m.

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