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    • #30329
      Xue Heng

      Hi, Steve.
      I’m sorry I have asekd so many question.
      But I really appreciate your detailed analysis of each case.
      The patient was a 65-year-old female with left shouder pain and restricted ROM.
      The long head of biceps tendon was swelling with fluid around it, which was consistent with tendinopathy.
      However, when I scanned to the proximal end of LHBT, a echogenic mass was observed.
      The rotator cuff was normal.
      The subdeltoid bursase was thickend which was consistent with bursitis.
      But I have no idea about the echogenic mass at the proximal end of LHBT and want your help.
      Thank you for your website and forum, Steve!

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    • #30425
      Stephen Bird

      Hi Xue,

      It is an unusual appearance,

      Part of me thinks it is just a bit, heterogeneous biceps anchor tendinosis.

      Another suggestion would be some CPPD in the superior glenohumeral ligament just medial to the LHBT.

      CPPD likes to walk through the SHGL and rotator suff cable.

      Could you see any crystal deposition in the cuff cable when you did your short axis supraspinatus images?

      The CPPD may show on a plain radiograph if you get one done.


    • #30450
      Xue Heng

      Thank you Steve, I didn’t see any crystal deposition.
      I would follow up the patient.
      Happy Lunar New Year!

    • #30456
      Stephen Bird

      Happy new lunar year to you Xue,

      We are looking forward to enjoying your winter olympics.

      I heard the summer olympics swimming cube has been made into the curling arena,

      Chelle and I have been there and it is a great venue,

      But I have never been there in winter.

      You always invite me in spring and autumn, which is the best weather.

      Next time I must come in the winter.

      I would be interested in a plain radiograph and if there is no CPPD I suspect you have a case of biceps anchor tendinosis and biceps tenosynovitis.

      Biceps anchor pathology is very common and unless you have good technique and follow the biceps right over the humeral head you miss it,

      It is often associated with instability of the biceps origin from a superior subscapularis partial tear.


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