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Acute Distal Triceps Tendon Rupture
 

Author: Simon Moskowitz, DO
Affiliation: The Ohio State University Medical Center
Co Author(s): Royce Onyimba, MD Michael Krill, MD
Senior Editor: Drew Duerson, MD

Clinical Vignette: 78-year-old male presenting to clinic after a fall at home with posterior elbow pain, bruising, and palpable defect just proximal to the olecranon.

Type of Probe Used: 12 MHz linear transducer



Short axis view at the level of the distal humerus, evaluating the triceps tendon/muscle, posterior fat pad, and olecranon fossa


Short axis view of the distal triceps tendon stump demonstrating loss of normal fibrillar structure of the triceps tendon. There is also anechoic and hypoechoic fluid signal, compatible with hematoma or seroma formation.


Unlabeled short axis view at the level of the distal humerus proximal to the olecranon fossa, evaluating the triceps tendon/muscle with evidence of bony avulsions.


Labeled short axis view of the distal triceps tendon stump showing loss of normal fibrillar structure of the triceps tendon, with discrete bony avulsions within the retracted triceps tendon. There is anechoic and hypoechoic fluid signal, compatible with hematoma or seroma formation.


Power Doppler imaging reveals increased peritendinous and intra-tendinous hyperemia at the site of fiber disruption.


Unlabeled long axis view of the posterior elbow with power Doppler


There is disruption of the distal triceps tendon fibers at the olecranon process, characterized by a hypoechoic defect and loss of normal fibrillar architecture at the tendon insertion, consistent with a distal tendon rupture. The proximal tendon stump appears retracted with intervening anechoic and hypoechoic fluid signal, compatible with hematoma or seroma formation. The olecranon bursa shows mild reactive fluid distention.


Unlabeled long axis view of the posterior elbow evaluating the region of the distal triceps insertion, with probe compression


Redemonstration of the distal tendon rupture, now with probe compression of the olecranon bursa and hematoma/seroma. Here, the posterior fat pad and distal humerus are labeled.


Unlabeled long axis view of the posterior elbow evaluating the region of the distal triceps insertion.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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