Long head of biceps tendon rupture

Long head of biceps tendon rupture

Rupture of the long head of biceps usually occurs in older adults and is due to constriction and degeneration of the tendon in the bicipital groove, especially at the superior end, beneath the anterior acromion. It is associated with rotator cu ff tears. Most patients present with few symptoms, although they often seek advice because of the bulge they notice in their arm. History and examination Patients feel a sense of ‘something giving way’ in front of the shoulder, sometimes with relief of pain if there was any present beforehand due to biceps tendinitis. The upper arm is bruised and elbow flexion produces a swelling in the front and middle of the arm ( Figure 38.22 ). The lump will be permanent and is initially tender. Power is slightly diminished in the early stages, when there may also be cramping pains on use of the arm. Treatment Reassurance that pain and bruising will resolve is su ffi cient. Power improves over several months and surgery (biceps tenodesis) is not needed for function, although it may help the cosmetic appearance. -

Figure 38.21 Arthroscopic end-on view of the clavicle after excision of its distal end. Figure 38.22 Bruising and change in the upper arm shape due to rupture of the long head of biceps.

Long head of biceps tendon rupture

Rupture of the long head of biceps usually occurs in older adults and is due to constriction and degeneration of the tendon in the bicipital groove, especially at the superior end, beneath the anterior acromion. It is associated with rotator cu ff tears. Most patients present with few symptoms, although they often seek advice because of the bulge they notice in their arm. History and examination Patients feel a sense of ‘something giving way’ in front of the shoulder, sometimes with relief of pain if there was any present beforehand due to biceps tendinitis. The upper arm is bruised and elbow flexion produces a swelling in the front and middle of the arm ( Figure 38.22 ). The lump will be permanent and is initially tender. Power is slightly diminished in the early stages, when there may also be cramping pains on use of the arm. Treatment Reassurance that pain and bruising will resolve is su ffi cient. Power improves over several months and surgery (biceps tenodesis) is not needed for function, although it may help the cosmetic appearance. -

Figure 38.21 Arthroscopic end-on view of the clavicle after excision of its distal end. Figure 38.22 Bruising and change in the upper arm shape due to rupture of the long head of biceps.

Long head of biceps tendon rupture

Rupture of the long head of biceps usually occurs in older adults and is due to constriction and degeneration of the tendon in the bicipital groove, especially at the superior end, beneath the anterior acromion. It is associated with rotator cu ff tears. Most patients present with few symptoms, although they often seek advice because of the bulge they notice in their arm. History and examination Patients feel a sense of ‘something giving way’ in front of the shoulder, sometimes with relief of pain if there was any present beforehand due to biceps tendinitis. The upper arm is bruised and elbow flexion produces a swelling in the front and middle of the arm ( Figure 38.22 ). The lump will be permanent and is initially tender. Power is slightly diminished in the early stages, when there may also be cramping pains on use of the arm. Treatment Reassurance that pain and bruising will resolve is su ffi cient. Power improves over several months and surgery (biceps tenodesis) is not needed for function, although it may help the cosmetic appearance. -

Figure 38.21 Arthroscopic end-on view of the clavicle after excision of its distal end. Figure 38.22 Bruising and change in the upper arm shape due to rupture of the long head of biceps.