Muscle Repair CASE REPORT Simultaneous Bilateral Biceps Tendon Rupture A Case Report with Practical Sonographic Diagnosis ABSTRACT Babaei-Ghazani A, Eftekhar-Sadat B, Ghabili K: Simultaneous bilateral biceps tendon rupture: a case report with practical sonographic diagnosis. Am J Phys Med Rehabil 2015;94:e13Ye18. Simultaneous bilateral complete tear of the biceps tendons is a rare clinical entity with challenging treatment approaches. Current diagnostic imaging of rupture of the biceps tendon has reverted to magnetic resonance imaging; however, in the recent years, sonography has been widely used in musculoskeletal practice. The authors present a case of simultaneous bilateral biceps tendon rupture diagnosed on the basis of fundamental sonographic findings of the torn biceps tendons. Key Words: Biceps, Tendon Rupture, Sonography, Musculoskeletal Rehabilitation S imultaneous complete rupture of both long head of biceps brachii tendons is a rare clinical entity mainly occurring in older individuals. This injury can have a detrimental effect on the level of function, and it is difficult to treat and may have poor outcome. The long head biceps tendon (LHBT) is a key stabilizer of the humeral head within the glenohumeral joint. The LHBT may be affected by several pathologic conditions such as acute or chronic tendonitis, subluxation or dislocation, and partial or complete tear. 1 Biceps tendon ruptures are commonly detected through exploring distal migration of the biceps brachii muscle mass. They may occur suddenly by a seemingly trivial event. Often, individuals will note an acute Bpopping[ sensation. 2 Herein, the authors report a patient with si- multaneous bilateral biceps tendon rupture diagnosed with sonography and treated with rehabilitation therapy. CASE PRESENTATION A 71-yr-old right-handed white man referred to the authors’ physical medicine and rehabilitation department with bilateral arm pain, swelling, and ecchymosis. The day before, while he was lifting an object from the ground to his chest level, he felt a sudden sharp pain in the anterior aspect of his right arm and shoulder. He immediately shifted the weight to his left arm, incurring another eccentric contraction at his shoulder, and he felt a similar pain on his left side. Both arms were in resisted flexion position, and both forearms were in supination. The pain and subsequent weakness in both shoulder and elbows persisted, precipi- tating his visit. Ecchymosis was more dominant on the left side (Fig. 1). Authors: Arash Babaei-Ghazani, MD Bina Eftekhar-Sadat, MD Kamyar Ghabili, MD Affiliations: From the Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran (AB-G); and Physical Medicine and Rehabilitation Research Center (BE-S) and Medical Philosophy and History Research Center (KG), Tabriz University of Medical Sciences, Tabriz, Iran. Correspondence: All correspondence and requests for reprints should be addressed to: Bina Eftekhar-Sadat, MD, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Daneshagh Street, Tabriz, Eastern Azerbaijan, Iran. Disclosures: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. 0894-9115/15/9402-e13 American Journal of Physical Medicine & Rehabilitation Copyright * 2014 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/PHM.0000000000000169 www.ajpmr.com Simultaneous Bilateral Biceps Tendon Rupture e13 Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.