1. Ventral view

Written by Jakub Jacisko, MD, PhDUpdated September 2026

Figure 1. Ventral view, transverse plane

b: long head of biceps tendon, TM: greater tubercle, tm: lesser tubercle.

TM and tm are the main anterior bony landmarks. The LHBB runs between them in the bicipital groove, a common location for detectable fluid because the tendon sheath communicates with the glenohumeral joint. In this view, also assess the subscapularis tendon, superficial deltoid layer, and fluid amount (physiologic versus synovitis).

Figure 1. Ventral view, transverse plane. b: tendon of the long head of biceps brachii, TM: tuberculum majus, tm: tuberculum minus

Transverse ultrasound section of the anterior part of the shoulder joint. The proximal humerus is displayed with the greater (TM) and lesser (tm) tubercle, between which the tendon of the long head of biceps brachii (b) is located in the intertubercular sulcus. In the surrounding area, the tendon of subscapularis inserting on the lesser tubercle of the humerus and the superficially located deltoid muscle are also visible, whereby this projection provides an overview of the main anatomical landmarks of the anterior part of the shoulder and enables targeted evaluation of tendons, soft tissues, and any pathological changes.

Clinical Note

The area around the long head of biceps tendon represents a typical site of fluid accumulation, because the tendon sheath communicates with the joint cavity; the presence of fluid in this location can therefore be a sign of effusion in the shoulder joint and requires careful assessment of its extent and character.

Figure 2. Ventral view, transverse plane

LHBB: long head of biceps, SHBB: short head of biceps.

A distal probe shift along the anterior arm evaluates the biceps brachii muscle belly with both heads clearly visible. This view is useful for muscle symmetry assessment and for detecting pathology such as partial or complete tears, hematoma, or atrophic change.

Figure 2. Ventral view, transverse plane. LHBB: long head of biceps brachii m., SHBB: short head of biceps brachii m.

Transverse ultrasound section of the anterior part of the arm with distal movement of the probe along the biceps brachii m. In this projection, both heads of the muscle are clearly visible, the long head (LHBB) and short head (SHBB), which form the muscle belly in the anterior region of the arm. This projection is suitable for assessing the structure and symmetry of the muscle belly and for detecting pathological changes such as partial or complete ruptures, hematomas, or signs of muscle atrophy.

Figure 3. Ventral view, sagittal plane

b: long head of biceps tendon.

After rotating the probe by 90 degrees, the LHBB is visualized in long axis within the bicipital groove. A healthy tendon has a linear fibrillar appearance; this plane is ideal for continuity assessment and for detecting fluid, tenosynovitis, and partial tears in anterior shoulder pain.

Figure 3. Ventral view, sagittal plane. b: tendon of the long head of m. biceps brachii

Longitudinal ultrasound section of the anterior shoulder, created by rotating the probe 90° from the transverse projection. The tendon of the long head of m. biceps brachii (b) is displayed in long axis in this plane as it courses through the intertubercular sulcus and shows the typical linear fibrillar appearance. This projection is essential for assessing tendon continuity and integrity and enables detection of pathological changes such as fluid around the tendon, tenosynovitis, or partial rupture.

Figure 4. Ventral view, sagittal plane

LHBB: myotendinous junction of the long head of biceps brachii.

With a more distal probe position, the myotendinous transition of the long head of biceps is shown, which is a frequent injury zone.

Figure 4. Ventral view, sagittal plane. LHBB: myotendinous junction of the long head of biceps brachii

Longitudinal ultrasound section of the anterior arm with more distal probe placement, showing the myotendinous junction area of the long head of biceps brachii (LHBB). In this projection, the transition from fibrillar tendon to hypoechoic muscle tissue is visible, corresponding to the transition from collagen fibers to muscle belly. This area represents a common site of injury and is important for detecting partial ruptures, tendinopathy, or muscle strain, especially in patients with anterior arm pain or following acute trauma.

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