Background: The biceps brachii is an important muscle of anterior compartment of arm. It shows frequent anatomic variability due to presence of supernumerary heads. Knowledge of the existence of the third head of biceps brachii is important for surgeons. Keeping this in mind a study was planned to see the incidence of additional head of biceps brachii in sample Indian population and to compare it with other racial groups.Methods: The study was carried out on 30 cadaveric upper limbs. The upper limbs were dissected and studied for the presence of additional head of biceps brachii. The attachment and nerve supply of the additional head was carefully observed, recorded and documented.Results: Out of 30 limbs which were dissected, additional head of biceps brachii was found only in two limbs. In both the cases the additional head was present only on the right side and arose from the anterior surface of humerus, superomedial to the origin of brachialis. The additional head fused with the common bulk of the muscle and was inserted into the radial tuberosity and bicipital aponeurosis. The extra heads of biceps brachii muscle received branches from musculocutaneous nerve.Conclusions: Biceps brachii is one of the commonest muscles showing variations. The additional head is not only of academic importance, but its knowledge also helps clinicians in managing fractures of humerus and nerve entrapment.
A 70-year-old man underwent Tc-methylene diphosphonate scintigraphy for staging of adenocarcinoma prostate. Scintigraphy revealed diffuse increased tracer uptake in skeletal system along with faint renal visualization, a pattern compatible with metastatic superscan. The scintigraphy also revealed increased radiotracer uptake in the body of the mandible-Lincoln sign or black beard sign. Radiological imaging revealed sclerotic lesions throughout the skeleton including the mandible, confirming widespread skeletal metastases. Lincoln sign is previously described in monostotic Paget disease of the mandible and in contiguous spread of oral malignancy. We describe this pattern in distant metastatic involvement from carcinoma prostate with coexistent superscan pattern.
Intrathoracic disease involving lungs and pleura encountered frequently and remains a challenging clinical problem.The definitive diagnosis of lung or pleural disease some times remain unclear despite thoracocentesis, closed pleural biopsy, transthoracic needle aspiration or bronchoscopy. Recent advances in endoscopic technique, video equipment and development of better instrumentation have contributed to the resurgence of thoracoscopy as a diagnostic and thoracoscopic modality.
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