Bilateral Simultaneous Elbow Injuries In An Avid Weight Lifter - Page #1

Author: John Matthews, MD
Co Author #1: John Matthews, MD
Co Author #2: William Wind, MD
Senior Editor: Jessalynn Adam, MD
Editor: Siobhan Statuta, MD, FAMSSM

Patient Presentation:
Patient presented to the office with complaints of bilateral elbow pain that occurred simultaneously while at the gym.

The patient is a 45-year-old right hand dominant male that presented to the office with chief complaint of bilateral elbow pain. He had no significant past medical or surgical history, but stated he was an avid weightlifter. He reported performing a pull up several days prior to presentation and during the eccentric phase, experienced a "pop" in both elbows with immediate pain and cramping. Over the next day he noticed increased swelling and ecchymosis over both elbows extending to the forearms and a deformity in both arms, more pronounced on the left. He presented to an emergency room for evaluation and was discharged with instructions to follow up in the Orthopaedic office. The patient denied any previous injuries or problems with both elbows as well as anabolic steroid use.

Physical Exam:
Visual inspection demonstrated swelling within the antecubital fossae and ecchymosis extending to the proximal lateral forearm of both elbows, more extensive on the left. There was an obvious deformity of both biceps musculature with proximal retraction of the muscle belly on the left. The deformity was accentuated with resisted elbow flexion. Both elbows demonstrated tenderness over the biceps tendon. On the right, the tendon was palpable in the antecubital fossa, not on the left. Bilateral ROM was 0-135 degrees of flexion and 80 degrees of pronation/supination. Strength testing demonstrated 4+/5 with supination and flexion on the right, 4/5 on the left. Distal neurovasculature was intact

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