Ever watched Popeye the sailor man, the famous cartoon character?
A
79-year-old man came to the orthopedic clinic with a 2-day history of an unusual
bulge on his left upper arm. The patient noticed this bulge right after he felt
a sharp pain in his left shoulder while lifting a heavy object.
On examination,
there was an obvious deformity on the anterior aspect of the left mid-upper arm.
On flexion of the left arm, the bulge became more prominent.
An
MRI (Magnetic resonance imaging) of the left shoulder was performed, which
showed a complete rupture of the long head of the biceps tendon.
Due to
the rupture, the long head of the biceps migrates distally, giving rise to the
well-defined bulge on elbow flexion, similar to that of the cartoon character
Popeye’s arm.
The bulge on his left upper arm due to biceps belly, secondary to the rupture of the biceps tendon, is called the “Popeye” sign or Popeye deformity, which is the hallmark of the bicep tendon tear, but an extremely rare find. It is typically seen in older people as with age the shoulder joint, the tendons, ligaments, and the associated muscles undergo degenerative changes due to both, age and overuse. طريقه لعب البوكر
This rupture is usually managed conservatively. Similarly, this patient was also managed nonoperatively with nonsteroidal anti-inflammatory drugs (NSAIDs). كيفيه لعب البوكر For patients whose occupations require full arm strength may require surgical repair of the ruptured tendon.
The
patient had recovered substantially at the 4-month follow-up. He had resumed
his activities of daily life with minimal or no pain.
What if the rupture is left untreated?
The
question is legit. If the rupture is not treated, investigated, and followed-up,
it will eventually, in the long run, lead to the replacement of the muscles
with fatty tissue; therefore, imaging studies are imperative to accurately diagnose
with subsequent appropriate treatment.
References
Naoki Yoshida, M.a. (2017, November 16). “Popeye” Sign. Retrieved from The New England Journal of Medicine: https://www. طريقة لعب بوكر nejm.org/doi/full/10.1056/NEJMicm1704705
