Elderly patient with mass on the right arm of sudden onset

Clinical introduction

An 83-year-old man with hypertension, type 2 diabetes, hypercholesterolaemia, stage 3 chronic kidney disease and bronchial asthma was admitted to the hospital for community-acquired pneumonia. The patient's home medications were candesartan, gliclazide, metformin, simvastatin and a combination of inhaled fluticasone and salmeterol; in the hospital, he was treated with intravenous levofloxacin and ceftriaxone. Although his pneumonia improved, on day 4 he experienced sudden pain and swelling in the anterior region of the right arm (figure 1).

Question

What is the most likely cause of the clinical presentation?

Bicipitoradial bursitis

Extravasation injury

Morel-Lavallee lesion

Proximal biceps avulsion

Answer: D

The physical examination revealed a palpable mass in the mid-upper arm corresponding to the belly of the biceps muscle (figure 1), more pronounced during elbow flexion. The absence of a history of trauma discounts options (A) and (C)....

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