A small bursa may develop between the long head of biceps tendon and the walls of the intertubercular (bicipital) groove of the humerus, facilitating smooth tendon gliding within the groove during shoulder rotation. It is distinct from the biceps tendon sheath, which is a synovial extension of the glenohumeral joint. The groove bursa is an adventitial structure that forms in response to friction from tendon pathology or groove osteophytes.
Bicipital groove bursitis contributes to the anterior shoulder pain of bicipital groove tendinopathy and may be demonstrated as a fluid collection around the proximal LHB tendon on ultrasound or MRI, distinct from glenohumeral joint effusion tracking into the tendon sheath. Treatment is the same as for bicipital groove tendinopathy: activity modification, anti-inflammatories, corticosteroid injection into the groove, and biceps tenodesis or tenotomy for refractory cases.
Inflammatory fluid within the bicipital groove bursa from LHB tendon irritation produces anterior shoulder pain at the groove level and a positive Speed test, demonstrated by ultrasound as a groove fluid collection, treated by guided corticosteroid injection into the groove and physiotherapy.
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