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Rupture of long head of biceps

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

The patient had left shoulder trauma about 15 days before the presentation. He presented with anterior mid-arm bulge known as pop-eye arm.

Patient Data

Age: 50 years
Gender: Male
ultrasound

The long head of the biceps tendon is hypoechoic and edematous in the bicipital groove. There is a loss of normal tendon echo pattern below the level of the bicipital groove favoring tendon tear. The tendon sheath is filled with fluid at this level. It is associated with sagging of myotendinous junction to mid-arm resulting in popeye arm.

The rest of the rotator cuff tendons were intact (images not uploaded).

The short-axis images should show sagging of the biceps myotendinous junction below the level of the pectoralis major insertion to the humerus.

Case Discussion

The patient presented with post-traumatic left anterior mid-arm swelling. It is known as a popeye sign caused by the rupture of the long head biceps tendon.

Ultrasound shows the long head biceps tendon rupture below the level of the bicipital groove. The rest of the rotator cuff tendons were intact.

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