Biceps Tendon Rupture Diagnosed by Physical Examination and Bedside Ultrasonography in the Emergency Department

Introduction: A complete tear of the proximal long head of biceps tendon is a rare clinical condition that is caused by direct or indirect trauma. We report the case of a patient with a proximal long-head biceps (PLHB) rupture diagnosed by bedside ultrasonography (BUS) and physical examination in the emergency department (ED). Case Report: A-55-year-old, right-handed man presented to ED with pain in the right shoulder and weakness in the elbow. Two days before, while he was lifting a 5-kg object from the ground, he felt a sudden pain, a burning sensation, and an audible pop in his right shoulder. On physical examination, there was a severe pain and tenderness over the anterior aspect of the shoulder, proximal part of the biceps muscle, and distally located biceps muscle mass. An emergency medicine physician performed BUS with a 7.5- to 12-MHz linear transducer. In BUS, there was a hypoechoic area in the right shoulder bicipital groove, but there were no tendon fibers. The evaluation of both the physical examination and sonographic findings revealed a PLHB rupture. Conclusion: BUS is a fast and cost-effective imaging method for the diagnosis of PLHB total rupture in ED.