• Shuji Katsuki, Hayato Terayama, Ryuta Tanaka, Ning Qu, Osamu Tanaka, Kanae Umemoto, Kaori Suyama, and Kou Sakabe.
• Department of Rehabilitation, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki-si Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si, Kanagawa, Japan.
• Medicine (Baltimore). 2018 May 1; 97 (20): e10708e10708.

IntroductionIn general, the long head of the biceps brachii (LHB) tendon arises from the supraglenoid tubercle in the shoulder joint, and it has an important stabilizing mechanism for the humeral head in the shoulder joint. This case demonstrates that even if the LHB tendon can be palpated outside of the shoulder joint, it may disappear in the intertubercular sulcus (IS) and in the glenohumeral (GH) joint because of abnormal articulation.Patient ConcernsThis case involved the cadaver of an 82-year-old Japanese man (number 1936, cause of death: hepatocellular tumor), who was selected from the bodies used for gross anatomy practice at the Tokai University School of Medicine in 2017.InterventionWe removed the fat and skin around the shoulder joint for observational purposes and carefully examined the gross anatomy of the structures.DiagnosisWe suspected that the long head of the biceps brachii tendon arose from the lesser tubercle (LT) in the cadaver. In our case, it was found that the upper part of the subscapularis (SSC) tendon was torn first, and the succeeding degenerative changes and rupture of the LHB tendon were intra-articular.OutcomesThe long head of the biceps brachii tendon was found to be ruptured in the GH joint, and scar tissue developed between the distal stump of the tendon and the articular capsule, resulting in fusion with the LT.ConclusionsThis case necessitates confirmation that the LHB tendon is present in the IS and in the GH joint to treat cases wherein failure of the dynamic stabilizing mechanism for the humeral head occurs.

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