Popeye Deformity
A 45-years old weight lifter while lifting the heavy weight in weight-lifting competition suddenly he felt a sudden snap and severe pain in the shoulder region. He dropped the weight and left the platform. He was taken to the hospital for checkup. On examination, the doctor noticed a ball-like bulge near the center of the distal part of the anterior aspect of the arm . the patient as not able to supinate his arm, and his forearm was pronated and flexed. A diagnosis of the rupture of the tendon of the long head of biceps was made.
Questions:
- What are the causes of the rupture of the tendon of the long head of biceps and which age group does it mostly affected?
- What is the origin of the long and short head of the bicep brachii?
- What caused the ball-like bulge in front of the arm and name this deformity?
Answer:
1. a) Rupture of the long head of the biceps tendon most commonly occurs due to chronic degeneration and tendinopathy of the tendon within the intertubercular (bicipital) groove of the humerus. It may also result from sudden forceful contraction of the biceps against heavy resistance, such as during weightlifting.
b) It is most commonly seen in adults over 40 years of age, particularly in individuals with pre-existing tendon degeneration.
2. a)The long head arises from the supraglenoid tubercle of the scapula and the superior part of the glenoid labrum.
b)The short head arises from the apex (tip) of the coracoid process of the scapula.
3. a) Retraction of the biceps muscle belly toward the distal arm following rupture of the long head tendon.
b) Popeye deformity (Popeye sign)
The patient typically presents with sudden shoulder pain, weakness of elbow flexion and forearm supination, and a prominent bulge in the distal arm due to retraction of the biceps muscle. These findings are characteristic of rupture of the long head of the biceps tendon.
