- This topic has 3 replies, 2 voices, and was last updated 3 years ago by
Stephen Bird.
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30/01/2022 at 3:53 pm #30329
Xue Heng
ParticipantHi, 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!Attachments:
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31/01/2022 at 5:29 pm #30425
Stephen Bird
KeymasterHi 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.
Steve.
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31/01/2022 at 10:51 pm #30450
Xue Heng
ParticipantThank you Steve, I didn’t see any crystal deposition.
I would follow up the patient.
Happy Lunar New Year! -
31/01/2022 at 11:25 pm #30456
Stephen Bird
KeymasterHappy 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.
Steve
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