– 7 year old MN French Bulldog with a subtle swelling over the left shoulder
– x-rays of the joint were unremarkable
– my associate was concerned about the possibility of a biceps tenosynovitis
– she had started treatment with laser and acupuncture
I made an attempt to scan the biceps tendon (with the D’Anjou textbook on my lap for reference while doing it so I could be completely off here!). Am I seeing the biceps tendon here and if so is it normal?
– 7 year old MN French Bulldog with a subtle swelling over the left shoulder
– x-rays of the joint were unremarkable
– my associate was concerned about the possibility of a biceps tenosynovitis
– she had started treatment with laser and acupuncture
I made an attempt to scan the biceps tendon (with the D’Anjou textbook on my lap for reference while doing it so I could be completely off here!). Am I seeing the biceps tendon here and if so is it normal?
I also scanned the region of the swelling (marked as lateral shoulder swelling). Looks like subcutaneous edema to me with some inflamed fat -any thoughts?
Comments
Dr. Ondreka is off for a few
Dr. Ondreka is off for a few days and she is the expert here but as a “ham and egg-er” ortho sonographer I’m seeing some hypoechoic areas in the last video at the biceps insertion but no full rupture…at the risk of getting completely contradicted by the expert I will stip there until Nele pops in lol
No problem – definitely not
No problem – definitely not an emergency here
there are only very mild
there are only very mild changes related to the biceps – such as a mild exostosis within the intertubercular groove and tiny core lesions (see image attached). but honestly the clinical significance of those is more than questionable. not only they are very tiny. there also is no thickening or tendon sheath effusion at all. so i seriously doubt the relevance of the biceps findings here.
the swelling looks more relevant to me. i would need more images/loops including power doppler to be more. but what i can say for sure is that this is contained within muscular tisse and does not look like edema. im thinking more of a hematoma & fibre disruption as seen in strain injuries. but really need to be cautious as there is unneglectable overlap with other disorders such as neoplasia. so what u can do here is stick it and scan the regional LN if you dont want to send more images.
Thank-you Dr. Ondreka. I will
Thank-you Dr. Ondreka. I will investigate the swelling more closely – good to know that this is muscle. I should be able to easily look at this again and we can do an FNA as well.