The bicipital groove synovial sheath surrounds the long head of biceps tendon as it exits the glenohumeral joint and passes through the bicipital groove of the humerus, extending approximately 3-5 cm distal to the groove. It is continuous with the glenohumeral joint synovium proximally.
The bicipital groove sheath is the site of bicipital groove tenosynovitis — a component of adhesive capsulitis and primary biceps pathology. Ultrasound-guided injection into the bicipital groove sheath anaesthetises the biceps tendon and communicates with the glenohumeral joint. The sheath is stripped from the groove during biceps tenodesis at the groove level.
Inflammation of the bicipital groove synovial sheath producing anterior shoulder pain reproduced by Speed and Yergason tests and groove palpation, communicating with the glenohumeral joint and responding to sheath injection.
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