Bicipitoradial bursitis
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Bicipitoradial bursitis refers to inflammation of the bicipitoradialbursa which is located between the distal biceps tendon and the tuberosity of the radius. The bursa partially or completely wraps around the biceps tendon. It ensures frictionless motion between the biceps tendon and the proximal radius during pronation and supination of the forearm.
The bicipitoradial bursa surrounds the biceps tendon in supination. In pronation, the radial tuberosity rotates posteriorly, which compresses the bicipitoradial bursa between the biceps tendon and the radial cortex which consequently increases the pressure within the bursa.
Epidemiology
It typically presents in adults and may be commonermore common in males
Clinical presentation
Patients often presents with elbow swelling, pain, tenderness, redness and limited movement.
Radiographic features
Ultrasonography
May show evidence of distention of the bicipitoradial bursa by fluid which appear anechoic or hypoechoic soft tissue. The distal biceps tendon should be evaluated for injury. Nodular soft-tissue debris and small calcifications may be seen within the fluid. Power Doppler imaging may show hyperaemia and suggests active inflammation.
MRI
-
T1
-: homogeneous hypointense signal mass in characteristic location. Associated; associated tendinosis of biceps tendon, thickening and intermediate signal intensity at insertion. -
T2
-: hyperintense flattened, oval, or round shaped cystic appearing mass that shows fluid signal intensity on all pulse sequences unless containing inflammatory debris or calcification +/-Ricerice bodies in patients with rheumatoid arthritis -
STIR
- as: as with T2 with more homogeneous fat saturation -
T1 C+ (Gd)
-: may demonstrate thin rim enhancement after gadolinium administration and homogeneous low central signal intensity.
Treatment and prognosis
Management options include
- acute
-: rest, antibiotics, NSAIDs and aspiration of infected fluid. - chronic
-: splinting and removal of foreign bodies.
Differential diagnosis
General differential considerations include
- biceps tendon tear or tendinosis
- posterior elbow dislocation
- osteochondritis dessicans of the capitulum
- radial head fracture
- other causes of antecubital mass
;, e.g. lipoma, hematoma, neuroma.
-<p><strong>Bicipitoradial bursitis</strong> refers to inflammation of the <strong>bicipitoradial</strong> <a title="Bursa" href="/articles/bursa">bursa</a> which is located between the distal biceps tendon and the tuberosity of the radius. The bursa partially or completely wraps around the biceps tendon. It ensures frictionless motion between the biceps tendon and the proximal radius during pronation and supination of the forearm. </p><p>The bicipitoradial bursa surrounds the biceps tendon in supination. In pronation, the radial tuberosity rotates posteriorly, which compresses the bicipitoradial bursa between the biceps tendon and the radial cortex which consequently increases the pressure within the bursa. </p><h4><strong>Epidemiology</strong></h4><p>It typically presents in adults and may be commoner in males</p><h4 style="font-size: 18px; background-color: rgb(255, 255, 255);">Clinical presentation</h4><p>Patients often presents with elbow swelling, pain, tenderness, redness and limited movement.</p><h4><strong>Radiographic features</strong></h4><h5>Ultrasonography</h5><p>May show evidence of distention of the bicipitoradial bursa by fluid which appear anechoic or hypoechoic soft tissue. The distal biceps tendon should be evaluated for injury. Nodular soft-tissue debris and small calcifications may be seen within the fluid. Power Doppler imaging may show hyperaemia and suggests active inflammation.</p><h5><strong style="line-height: 1.5;">MRI</strong></h5><div><ul>-<li>-<strong>T1</strong> - homogeneous hypointense signal mass in characteristic location. Associated tendinosis of biceps tendon, thickening and intermediate signal intensity at insertion.</li>-<li>-<strong>T2</strong> - hyperintense flattened, oval, or round shaped cystic appearing mass that shows fluid signal intensity on all pulse sequences unless containing inflammatory debris or calcification +/- Rice bodies in patients with rheumatoid arthritis</li>-<li>-<strong>STIR</strong> - as with T2 with more homogeneous fat saturation</li>-<li>-<strong>T1 C+ (Gd)</strong> - may demonstrate thin rim enhancement after gadolinium administration and homogeneous low central signal intensity.</li>-</ul></div><h4>Treatment- </h4><p>Management options include</p><ul>-<li>acute - rest, antibiotics, NSAIDs and aspiration of infected fluid.-</li>-<li>chronic - splinting and removal of foreign bodies.-</li>- +<p><strong>Bicipitoradial bursitis</strong> refers to inflammation of the <a href="/articles/bicipitoradial-bursa">bicipitoradial bursa</a>. </p><p>The bicipitoradial bursa surrounds the biceps tendon in supination. In pronation, the radial tuberosity rotates posteriorly, which compresses the bicipitoradial bursa between the biceps tendon and the radial cortex which consequently increases the pressure within the bursa.</p><h4><strong>Epidemiology</strong></h4><p>It typically presents in adults and may be more common in males</p><h4>Clinical presentation</h4><p>Patients often presents with elbow swelling, pain, tenderness, redness and limited movement.</p><h4><strong>Radiographic features</strong></h4><h5>Ultrasonography</h5><p>May show evidence of distention of the bicipitoradial bursa by fluid which appear anechoic or hypoechoic soft tissue. The distal biceps tendon should be evaluated for injury. Nodular soft-tissue debris and small calcifications may be seen within the fluid. Power Doppler imaging may show hyperaemia and suggests active inflammation.</p><h5><strong>MRI</strong></h5><ul>
- +<li>
- +<strong>T1</strong>: homogeneous hypointense signal mass in characteristic location; associated tendinosis of biceps tendon, thickening and intermediate signal intensity at insertion</li>
- +<li>
- +<strong>T2</strong>: hyperintense flattened, oval, or round shaped cystic appearing mass that shows fluid signal intensity on all pulse sequences unless containing inflammatory debris or calcification +/- rice bodies in patients with rheumatoid arthritis</li>
- +<li>
- +<strong>STIR</strong>: as with T2 with more homogeneous fat saturation</li>
- +<li>
- +<strong>T1 C+ (Gd)</strong>: may demonstrate thin rim enhancement after gadolinium administration and homogeneous low central signal intensity</li>
- +</ul><h4>Treatment and prognosis</h4><p>Management options include</p><ul>
- +<li>acute: rest, antibiotics, NSAIDs and aspiration of infected fluid</li>
- +<li>chronic: splinting and removal of foreign bodies</li>
-<li>biceps tendon tear or tendinosis </li>-<li><a title="Posterior elbow dislocation" href="/articles/elbow-dislocation">posterior elbow dislocation</a></li>-<li>-<a title="Osteochondritis dessicans" href="/articles/osteochondritis-dessicans">osteochondritis dessicans</a> of the capitulum </li>-<li>-<a title="Radial head fracture" href="/articles/radial-head-fractures">radial head fracture</a> </li>-<li>other causes of antecubital mass; e.g. lipoma, hematoma, neuroma.</li>- +<li>biceps tendon tear or tendinosis </li>
- +<li><a href="/articles/elbow-dislocation">posterior elbow dislocation</a></li>
- +<li>
- +<a href="/articles/osteochondritis-dessicans">osteochondritis dessicans</a> of the capitulum </li>
- +<li>
- +<a href="/articles/radial-head-fractures">radial head fracture</a> </li>
- +<li>other causes of antecubital mass, e.g. lipoma, hematoma, neuroma</li>
Images Changes:
Image 3 MRI (T1 C+ fat sat) ( create )
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