Images in clinical medicine: Popeye's sign

نویسندگان

  • Shobhit Gupta
  • Andy Crocker
  • Jorge Scheirer
  • Richard Alweis
چکیده

A 72-year-old male with a history of bilateral rotator cuff tears presented to his primary care physician (PCP) with complaints of chronic shoulder pain and fatigue. Upon physical examination, a palpable mass was noted between his left shoulder and elbow, although he could not recall when the mass first appeared. Left arm cogwheel rigidity was also noted on physical examination. He denied any tenderness to the left shoulder, elbow, or previous mass palpation. The location of the mass is consistent with Popeye’s sign, a hallmark of biceps tendon rupture (Fig. 1). He was referred to an orthopedic surgeon for evaluation but opted instead to strengthen his shoulder through physical therapy. The biceps brachii muscle primarily functions as a forearm supinator (1). The muscle is formed by a long and short head that share a distal tendon attachment site, but have distinct proximal tendon attachment sites on the scapula (2). Rupture of the biceps tendon can occur at either the proximal or distal sites, although distal rupture is rare (1). The mechanism of injury can range from degenerative changes in the elderly to athletic injuries related to weight lifting or throwing in younger patients. Trauma at any age can result in a biceps tendon rupture, and these injuries are often associated with a ‘popping’ sound. Clinical manifestations of ruptures often include a sudden onset of sharp shoulder pain, ecchymosis, and swelling (3). In patients with chronic shoulder pain, however, an acute rupture may improve pain quality (3). As noted in Fig. 1, acute tendon rupture is classically associated with the ‘Popeye’ deformity, a visible or palpable mass present near the elbow or in the midupper arm (3). Diagnosis of a biceps tendon rupture is primarily made by history, inspection, and palpation. Imaging modalities such as MRI or ultrasound may be helpful to delineate a complete versus partial rupture, but are otherwise unnecessary to make a diagnosis (1). There are no consensus guidelines on indication for surgical repair, although distal ruptures seem to have greater clinical benefit from repair as these patients have significant defects on their physical examination (1). Chronic tears become increasingly more challenging to treat due to possible tendon contraction and poor tissue quality but tendon grafts have been successfully used for these cases (1). Active patients who depend on arm strength, such as athletes, may be appropriate candidates for surgical referral.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Evaluation of the results from arthroscopic tenodesis of the long head of the biceps brachii on the tendon of the subscapularis muscle.

OBJECTIVES The aim of this study was to evaluate the results from arthroscopic tenodesis of the long head of the biceps brachii (LHBB) on the tendon of the subscapularis muscle, with regard to the presence of pain, subscapularis lesion, presence of Popeye's sign and patient satisfaction. METHODS A prospective cohort study was conducted on 32 patients with LHBB lesions, through preoperative in...

متن کامل

The semicolon sign: dopamine transporter imaging artifact from head tilt.

Dopamine transporter (DAT) imaging is a valuable tool to aid in the diagnosis of Parkinson disease and other Parkinsonian syndromes. DAT imaging is special among clinical nuclear medicine scans in that the already small caudate and putamen are presented in multiple thin axial cuts. Because the imaged basal ganglia are small, slight differences in head tilt may result in a significant artifact t...

متن کامل

Use of three-dimensional ultrasonography of the eye and measurement of optical long axis in dog

This study was conducted to determine the use of three-dimensional ultrasonography (3DU) in ocular imaging of the dog and measuring of its optical axis. 12 healthy mixed-breed dogs including 6 males and 6 females were studied. 3DU of the eyes were done using a 5–12 MHz linear trapezoid transducer. 3DU of the eyes were evaluated and the normal optical long axis through a line between the cornea ...

متن کامل

Nitrosative stress indices in dogs with neurological form of canine distemper

This is a prospective, controlled, randomized clinical study to evidence the role of nitrosative stress in development of overt neurological sign of canine distemper (CD). The enrollment of cases wasa made on basis of overt sign of CD (n=139) and the findings were compared with apparently healthy dogs (n=15). The CD specific immunoglobulins resulted in 94 confirmed positive cases. The nitric ox...

متن کامل

Three Dimensional Ultrasonography of the Eye and Measurement of Optical Nerve Sheet Diameter in Dog

Objective-  To determine the possibility of three-dimensional ultrasonography (3DUS) and measurement of optical nerve sheet by this method. Design- Descriptive study. Animals- 10 mixed normal dogs (5males, 5 females), age 1-1.5 year, and weighting 15±5 kg Procedure- 3D ultrasounds of the eyes were evaluated and the normal optical nerves in 3DUS images were measured using Volouson 730 pro....

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 3  شماره 

صفحات  -

تاریخ انتشار 2013