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Introduction: Among ex-opioid users on methadone maintenance therapy MMT , the prevalence of chronic severe pain CSP was reported as The CSP causes distress, adversely affects quality of life, addiction treatment outcome and exacerbates patients ambivalence towards MMT. Neuroticism personality trait is associated with CSP, but the similar association has yet to be explored in ex-opioid users on MMT. Otherwise, no significant association was observed for depression, HIV status, regular use of kratom, and other socio-demographic or clinical characteristics. This site uses cookies. Find out more on how we use cookies. Published February 1, Version v1. Journal article Open. Files Name Size Download all Koh. Jump up. Accept all cookies Accept only essential cookies. Preview Download.

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Official websites use. Share sensitive information only on official, secure websites. A year-old Chinese man presented to us for sudden onset of right arm pain and swelling. He was a car mechanic. This was followed by intense pain, swelling and weakness in the right arm. On clinical examination, there was a swelling at his right arm, seen more prominent when he flexed his elbow figure 1. Sonography of the right shoulder showed absence of biceps tendon within the bicipital groove of the right humerus figure 2. He was treated conservatively. He was asked to rest his arm and prescribed non-steroidal anti-inflammatory drugs for pain relief. Subsequently he underwent physiotherapy for muscle strengthening, and rehabilitation exercises. Sonography of bilateral shoulders. A and B Transverse view, C and D longitudinal view. Red arrow shows absence of biceps tendon within the right bicipital groove A and C , white arrow shows normal biceps tendon within the left bicipital groove B and D. Biceps tendon rupture is not uncommon. Clayton and Court-Brown reported the incidence of biceps tendon rupture as 0. Our patient is a chronic smoker who used his arms strenuously in his daily work, therefore he was at risk of a biceps tendon tear. Ultrasonographic examination of the shoulder has becoming a reliable tool to diagnose biceps tendon tear. Surgical intervention is indicated only if conservative therapy fails, or in a selected group of patients with concomitant shoulder pathology. Majority of the patient will be able to return to work without significant restriction. Ultrasonographic examination could be a non-expensive, easily available diagnostic tool to help to confirm the diagnosis. Contributors: CHL: conceptual, preparing manuscript, image, proof read. KAL: manage patient, image, proof read. JWL: manage patient, proof read. Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. As a library, NLM provides access to scientific literature. BMJ Case Rep. Find articles by Chong Hong Lim. Find articles by Kok An Lee. Find articles by Joe Wei Liew. Accepted Jan 19; Collection date Keywords: musculoskeletal syndromes, rheumatology, radiology, orthopaedics. No commercial re-use. See rights and permissions. Published by BMJ. Open in a new tab. Provenance and peer review: Not commissioned; externally peer reviewed. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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