Written by Sander van Bergen20-02-2014 13:00:00. Posted in Upper extremity

Test your knowledge: musculoskeletal ultrasonography of the upper arm

Question:

Musculoskeletal ultrasonography is an accurate way to test anatomical structures for inflammation, tears or discontinuity. Last week, a patient (woman of 72 yrs, active lifestyle) visited the practice presenting with pain in her upper arm, just above the elbow joint. No traumatic moment was reported, ruling out tears or other major injuries. The pictures in the banner above show the arm of this patient and an ultrasonographic panoramic photo of the upper arm of the patient. 

Do you know the injury this patient has sustained? 

Answer:

This patient has had a degenerative rupture of the tendon of the long head of the biceps. It sometimes occurs spontaneously during a non-weight-bearing movement, especially in elderly, like in this particular case. The place of rupture is almost always at the less vascularized part of the long head of the biceps brachii tendon. You can see the vascularity of the biceps muscle and tendon in the picture below.