Presentation
Left shoulder mild pain. Normal range of movements. Non-diabetic. Left arm dominance. No recent/ remote prior trauma.
Patient Data
A thin-walled, anechoic, non-compressible fluid involving the biceps long-head tendon. It starts from the bicipital groove and reaches up to the myotendinous junction. The craniocaudal measurement is 90 mm. Normal biceps long head tendon at the cranial end of the bicipital groove and in the rotator interval region. At the cyst level, the tendon fibers are present anterolateral. Normal distal biceps tendon.
Normal supraspinatus and infraspinatus tendon. Focal altered echopattern in the subscapularis tendon favors tendinosis. No fatty infiltration/ volume loss of supraspinatus and infraspinatus muscle bellies. Acromioclavicular joint superior capsular thickening.
No subacromial-subdeltoid bursitis/ glenohumeral joint effusion.
Case Discussion
The case shows a gigantic ganglion cyst of the biceps long head tendon.
A differential diagnosis is biceps tendon sheath effusion which should be compressible and reducible with arm elevation as it communicates with the glenohumeral joint.
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