Intertubercular tendon sheath

The intertubercular tendon sheath refers to the distal continuation of the synovial sheath that envelops the long head of the biceps brachii tendon as it exits the shoulder joint cavity. Once it leaves the joint capsule, the tendon passes through the intertubercular sulcus (or bicipital groove) of the humerus, where the tendon (or synovial) sheath extends caudally beneath the transverse humeral ligament.

Function and clinical correlate

The intertubercular tendon (synovial) sheath facilitates smooth, frictionless movement of the biceps tendon within the groove during shoulder and elbow motion. Clinically, inflammation or degeneration of the sheath and tendon (bicipital tenosynovitis) can produce anterior shoulder pain, often evident on ultrasound or MRI.