Abstract
Congenital absence of the long head of the biceps (LHB) tendon is a rare variation in shoulder anatomy. The authors present a case of congenital absence of the long head of the biceps tendon associated with a large insertion of the subscapularis muscle. The patient initially presented with shoulder pain on overhead activity. Shoulder examination was negative for signs of a torn biceps tendon. MRI revealed congenital absence of the LHB tendon, a rim rent tear of the supraspinatus, and a large insertion of the subscapularis muscle. This is the first reported case describing a large insertion of the subscapularis muscle associated with absence of the LHB tendon.5
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Dierickx C, Ceccarelli E, Conti M, Vanlommel J, Castagna A. Variations of the intra-articular portion of the long head of the biceps tendon: a classification of embryologically explained variations. J Shoulder Elb Surg. 2009;18(4):556–65.
Foad A, Faruqui S. Case report: absence of the long head of the biceps brachii tendon. Iowa Orthop J. 2016;36:88–93.
Franco J, Knapp T, Madelbaum B. Congenital absence of the long head of the biceps tendon. J Bone Joint Surg Am. 2005;87(7):1584–6.
Ghalayini SRA, Board TN, Srinivasan MS. Anatomic variations in the long head of biceps: contribution to shoulder dysfunction. Arthroscopy. 2007;23(9):1012–8.
Glueck DA, Mair SD, Johnson DL. Shoulder instability with absence of the long head of the biceps tendon. Arthroscopy. 2003;19(7):787–9.
Keefe DT, Lowe WR. Symptomatic superior labral anterior posterior lesion with absence of the long head of the biceps tendon: a case report. Am J Sports Med. 2005;33(11):1746–50.
Koplas MC, Winalski CS, Ulmer WH, Recht M. Bilateral congenital absence of the long head of the biceps tendon. Skelet Radiol. 2009;38(7):715–9.
Kuhn KM, Carney J, Solomon D, Provencher M. Bilateral absence of the long head of the biceps tendon. Mil Med. 2009;174(5):548–50.
Maldjian C, Borrero C, Adam R, Vyas D. Nature abhors a vacuum: bilateral prominent rotator cable in bilateral congenital absence of the long head of the biceps tendon. Skelet Radiol. 2014;43(1):75–8.
Mariani PP, Bellelli A, Botticella C. Arthroscopic absence of the long head of the biceps tendon. Arthroscopy. 1997;13(4):499–501.
Pandey V, Vijayan S, Hafiz N, Deepika N, Acharya K. Does congenital absence of the long head of biceps tendon render shoulder unstable leading to bony bankart and posterior labral tear: a case report and review of the literature. J Musculoskelet Res. 2016;19(01):1672001.
Rego Costa F, Esteves C, Melão L. Bilateral congenital agenesis of the long head of the biceps tendon: the beginning. Case Rep Radiol. 2016;2016:1–5.
Sayeed SA, Shah JP, Collins MS, Dahm DL. Absence of the long head of the biceps tendon associated with glenoid dysplasia and posterior labral tear. Clin Anat. 2008;21(7):728–32.
Smith E, Matzkin E, Kim D, Harpstrite J, Kan D. Congenital absence of the long head of the biceps brachii tendon as a VATER association. Am J Orthop. 2002;31(8):452–4.
Winston BA, Robinson K, Crawford D. “Monocept”: a brief report of congenital absence of the long head of the biceps tendon and literature review. Case Rep Orthop. 2017;2017:1–3.
Rodríguez-Niendenführ M, Vázquez T, Choi D, Parkin I, Sañudo JR. Supernumerary humeral heads of the biceps brachii muscle revisited. Clin Anat. 2003;16(3):197–203.
Standnick ME. Pathology of the long head of the biceps tendon. Radsource MRI Webclinic. 2014. http://radsource.us/pathology-of-the-long-head-of-the-biceps-tendon/.
Itoi E, Kuechle DK, Newman SR, Morrey BF, Itoi E, Kuechle DK. Stabilising function of the biceps in stable and unstable shoulders. J Bone Joint Surg. 1993;75:546–50.
Kim S, Ha K, Kim H, Kim S. Electromyographic activity of the biceps brachii muscle in shoulders with anterior instability. Arthroscopy. 2001;17(8):864–8.
Rodosky MW, Harner CD, Fu FH. The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder. Am J Sports Med. 1994;22(1):121–30.
Ide J, Tokiyoshi A, Hirose J, Mizuta H. An anatomic study of the subscapularis insertion to the humerus: the subscapularis footprint. Arthroscopy. 2008;24(7):749–53.
Richards DP, Burkhart SS, Tehrany AM, Wirth MA. The subscapularis footprint: an anatomic description of its insertion site. Arthroscopy. 2007;23(3):251–4.
Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med. 2009;39(8):663–85.
Braun S, Horan MP, Elser F, Millett PJ. Lesions of the biceps pulley. Am J Sports Med. 2011;39(4):790–5.
Rahman H, Currier E, Johnson M, Goding R, Wagoner Johnson AJ, Kersh M. Primary and secondary consequences of rotator cuff injury on joint stabilizing tissues in the shoulder. J Biomech Eng. 2017;139(11):1–10.
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El Abiad, J., Faddoul, D.G. & Baydoun, H. Case report: Broad insertion of a large subscapularis tendon in association with congenital absence of the long head of the biceps tendon. Skeletal Radiol 48, 159–162 (2019). https://doi.org/10.1007/s00256-018-2989-2
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DOI: https://doi.org/10.1007/s00256-018-2989-2