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Intratendinous ganglion cyst of long head biceps

Case contributed by Domenico Nicoletti
Diagnosis almost certain

Presentation

Left shoulder pain.

Patient Data

Age: 60 years
Gender: Female

Left shoulder

mri

The extra-articular component of the long head biceps tendon is markedly degenerated with intratendinous cyst formation. In the sagittal DP fat sat sequence, long head of the biceps tendon shows the intratendinous located pedicle of the ganglion, which gradually extends distally, thereby stretching the fibers of the long head of the biceps tendon.

There is also partial thickness tear of the articular side of the supraspinatus tendon.

Case Discussion

A ganglion is a well-defined, lobulated mass located adjacent to a tendon, ligament or a joint. A fluid-filled stalk or pedicle that connects to the adjacent joint or tendon sheath is a reliable sign of a ganglion. MRI signal characteristics of intratendinous ganglion are typical of other ganglions with homogenous low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. The supraspinatus tendon partial thickness tear is suggested to be more responsible for the patient's complaint.

 

Case courtesy: Dr.ssa Barbara Severini

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