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Bicipitoradial bursitis

Bicipitoradial bursitis refers to inflammation of the bicipitoradial bursa

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 more 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 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 +/- rice bodies in patients with rheumatoid arthritis
  • STIR: 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


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