Distal biceps tendon injection.

BACKGROUND: Injection therapy around the distal biceps tendon insertion is challenging. This therapy may be indicated in patients with a partial distal biceps tendon tear, bicipitoradial bursitis and tendinopathy. The primary goal of this study was to determine the accuracy of manually performed injections without ultrasound guidance around the biceps tendon. METHODS: Seven upper limb specialists, two general orthopedic specialists, and three orthopedic surgical residents manually injected a cadaver elbow with acrylic dye using an anterior and a lateral infiltration approach. After infiltration the cadaveric elbows were dissected to determine the location of the acrylic dye. RESULTS: In total, 79% of the injections were localized near the biceps tendon. Of these injections, 20% were localized on the radius near the bicipitoradial bursa. In total, 53% of the performed infiltrations were injected by anterior and 47% by lateral approaches. Of the injections near the distal biceps (79%), 47% were injected by an anterior and 53% by a lateral approach. Of the injections on the radius (20%), 33% were injected by anterior and 67% by lateral approach. Of the inaccurate injections (21%), 75% were injected anterior and 25% lateral. CONCLUSION: Manual infiltration without ultrasound guidance for distal biceps pathology lacks accuracy. We therefore recommend ultrasound guidance for more accurate infiltration.

Synchronous bilateral lipoma arborescens of bicipitoradial bursa-a rare entity.

Lipoma arborescens is a rare non-neoplastic condition that affects the synovial lining of joints and bursae accounting for less than 1% of all lipomatous lesions. Characterized by villous proliferation of the synovium, it is an uncommon cause of intra/periarticular mass presenting as a painless, slowly progressive longstanding swelling, and is sometimes accompanied by intermittent monoarticular effusions. We describe a rare case of bilateral lipoma arborescens in the bicipitoradial bursae in a young male referred for MRI evaluation of spontaneous bilateral elbow swelling. We chose to bring this case to light because of the rare simultaneous involvement of the bicipitoradial bursae bilaterally and the role of MR in providing a definite diagnosis, hence obviating the need for biopsy and avoiding consideration of other complex intra/periarticular masses.

Preoperative diagnosis of bicipitoradial bursitis: a case report.

Inflammation of the bicipitoradial bursa is a rare condition and only few reports can be found in literature. Several causes for a cubital bursitis have been suggested in the past. The need to include a malignant lesion in the differential diagnosis has only been mentioned in one of these reports. May main objective in reporting this case is to make this pathological entity better known.

Bicipitoradial Bursitis: A Case Report

Case Report: We report a case of bicipitoradial bursitis, which is a rare mass lesion in cubital fossa. A 54-year-old woman visited our clinic with onemonth history of anterior elbow discomfort and mass lesion. She had a movable and hard mass lesion in cubital fossa. We checked imaging study with simple radiography and MRI. There was a 3.4x2.6x2.7 cm sized cystic mass lesion between biceps tendon and radial tuberosity with inflammatory change in the adjacent tissue on MRI. Enlarged bursa wrapping around the distal biceps tendon was excised and bursitis was confirmed by histologic examination. Bicipitoradial bursitis is a rare disease condition and must be differentiated with other neoplasm in cubital fossa.