Transverse Humeral Ligament: True Ligament or Expansion from Adjacent Tendons

The main features of the upper end of the humerus are the presence of greater and lesser tubercles, with the bicipital groove intervening between these tubercles. The bicipital groove, also known as the intertubercular sulcus, houses the tendon of the long head of the biceps brachii muscle. As per the classical description, the bicipital groove is bridged by the transverse humeral ligament. But literature search including histological studies revealed that tissue overlying the bicipital groove is not a ligament; instead, the tissue covering the bicipital groove consists of tendinous fibres from the subscapularis and supraspinatus muscles. Thus, the aim of this chapter is to establish whether the tissue bridging the bicipital groove is ligament or tendinous fibres from various muscles constituting the rotator cuff. In this chapter, data from various radiological studies consisting of MRI, including dissection and histological studies, have been expounded to validate the presence of tissue over the bicipital groove, i.e. whether it is ligament or tendinous fibers.