Acromioclavicular joint ganglion and long head of biceps brachii dislocation

Case contributed by Brendan Cullinane
Diagnosis probable


Swelling at the AC joint.

Patient Data

Age: 80 years
Gender: Female

Non-compressible, cystic mass at the site of the swelling, which appeared to communicate with the AC joint.

The biceps tendon has dislocated medially out of the bicipital groove. It appears thin and irregular, likely due the lipping seen at the groove in the image on the left.

Dislocation of the tendon out of the groove implies rupture of the transhumeral ligament, which is an extension of the coracohumeral ligament over the groove. This is likely due to tearing seen at the distal insertion of the subscapularis tendon, which lies adjacent to the groove.

Case Discussion

A very old shoulder in bad repair. The more interesting findings are shown here

A ganglion was seen communicating with the AC joint. Dislocation of the long head of biceps tendon medially out of the bicipital groove implied rupture of the transhumeral ligament. The biceps tendon appeared degenerated, probably due to marked lipping at the groove, however it had not completely torn. The posterior labrum had a degenerated appearance and was probably torn. Effusions were seen within the biceps tendon sheath and subscapular joint recess. 

There were numerous other degenerative changes.

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