Proximal rupture of long head biceps brachii tendon

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Injury while heavy lifting. ? Biceps rupture

Patient Data

Age: 45
Gender: Male

Complete rupture of the long head biceps brachii tendon with the proximal component of the tendon retracted above the glenohumeral articulation maintaining attachment to the superior glenoid labrum.  The distal component of the ruptured biceps tendon sits at the lower aspect of the bicipital groove. Separation between the two tendon components is around 8cm. Subentheseal cysts and bony irregularity associated with the subscapularis tendon insertion at the upper aspect of the bicipital groove may have predisposed to attritional biceps tendon failure at this site.  Additional findings include partial tearing of the supraspinatus tendon insertion (rim rent tear), small acromial spur and glenohumeral joint effusion with mild synovitis /debris. 

Case Discussion

Proximal long head of biceps brachii tendon rupture with substantial retraction / separation. Bony irregularity at the proximal aspect of the bicipital grove underlying the subscapularis tendon insertion may have resulted in attritional wear of the biceps tendon at this site. A supraspinatus partial insertion 'rim rent' type tendon tear is also seen. 

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