Long head of biceps tendon tear

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Snap in right shoulder - arm while lifting heavy object - Few hrs. His daily work involves lifting heavy objects. C/o shoulder pain with mid third of anterior arm swelling. On examination - 'popeye' arm.

Patient Data

Age: 55 yrs
Gender: Male
ultrasound

There is absent long head of bicipital tendon in bicipital groove as well as cranial to groove level. There is sagging of myotendinous junction of long head biceps. Torn end of long head biceps tendon is present in anterior mid arm level. The long tendon is folded upon itself. 

Supraspinatus, infraspinatus and subscapularis tendons are intact and show normal echopattern.  Supraspinatus and infraspinatus muscle bellies show normal bulk and echopattern. There is no subacromial-subdeltoid bursal effusion or gleno-humeral joint effusion.

Case Discussion

55 yrs old male presented with shoulder snap and mid arm bulge after lifting heavy object. Clinically, there is popeye arm; which occurs when long head biceps tendon is completely torn and it saggs at mid arm level. 

Ultrasound findings confirmed clinically diagnosis of long head biceps tendon tear.

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