I used the Euclidean algorithm to show that 21∗109−44∗52=1, but how does that help get the 65?
You want $52x \equiv 1 \pmod{109}$.
That means there is an integer $k$ so that $52x = 1 + 109k$
That means $109(-k) + 52x = 1$.
Use Euclid algorithm to find that.
You got $21*109 -44*52 =1$. So if we let $x = -44$ and $k=-21$ we done:
$-44*52 = 1- 21*109$
So $-44*52 \equiv 1\pmod{109}$ and
$x \equiv -44$ is an multiplicative inverse of $52$.
To express $x$ and an equivalence class where $0\le x < 109$ we
just note that $x \equiv -44 \equiv -44 + 109 \equiv 65\pmod{109}$.
But we may express $x$ as any equivalence representation of $65$. We may have $x\equiv -44$ or $x \equiv 174$ or $x\equiv -153$ or ... whatever.
.....
Or if it helps:
$21*109 - 44*52 = 1$
$21*109 -44*52 + 109*52-109*52 = 1$
$(21-52)*109 + (-44 + 109)*52 =1$
$-31*109 + 65*52 = 1$.
So $1 = 65*52 - 31*109$
So $1 \equiv 65*52\pmod {109}$