ORTHOPAEDICS


Case 15 :
A 50-year-old male presents with H/o direct hit to elbow 6 days ago, and now can feel gap in the muscle above elbow; presently no pain or swelling. MRI has been performed. What is the diagnosis?
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Imaging Diagnosis
Rupture of biceps tendon

Discussion
Common in men, it occurs in the dominant arm in 80%, and is commonly seen in body builders & weight lifters at younger age. It is accentuated by steroid abuse
Complete rupture of tendon from its radial insertion is most common, besides, can also rupture at:

  • Rupture of long head
  • Rupture of muscle belly or myotendinous junction rare, sec to direct trauma.
  • Distal biceps tendon injury- attempt to lift heavy object
  • Tearing of lacertus fibrosus- prox retraction of biceps

MRI FEATURES:

  • Biceps tendinosis precedes rupture
  • Hypovascular zone 1 cm proximal to insertion
  • Gets impinged between radius & ulna on pronation
  • MRI differentiates between complete , partial tears and tendinosis

MANAGEMENT

  • Prompt surgical repair and reattachment
  • Surgical outcome improves when treated in first several weeks




MRI Centre, Nanavati Hospital, Mumbai
DR DEEPAK PATKAR, DR MALINI LAWANDE, DR SONA PUNGAVKAR,
DR SHILPA SANKHE, DR ANKIT TANDON & DR NISHA SAINANI