Dear colleagues,
I would like to request your assistance with a case involving a 36-year-old patient who has been experiencing elbow pain during pronation and supination for several months now.
He has no significant medical history, particularly no personal or family history of inflammatory rheumatism. He does not engage in any activities that could potentially overstrain his biceps brachii tendon.
The pain is of a mixed nature, both mechanical and inflammatory. There is no fever. Imaging reveals a proximal radioulnar oval-shaped formation, near the bicipitoradial enthesis. The tendon itself appears perfectly normal.
I find the image very atypical for bursitis. There is a peripheral enhancement ring. A periosteal reaction is observed on the CT sca, and erosion. There is no communication with the intra-articular cavity itself, as showed by the arthroTDM (+1 hour).
Several of my colleagues suspect a tissue lesion. What do you think about this hypothesis ?
What do you think about the feasibility of a percutaneous biopsy at this level, considering the anatomical relationship with the posterior interosseous nerve?
Thank you very much for any assistance you can provide.
PS: Newly registered in this community and this is my first post! I think this initiative is wonderful.
Eric B
France
