Distal Biceps Tendon Rupture

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Distal Biceps Tendon Rupture

Authors, Editors, Case Information Author: Kyle Samyn, DO, MS Affiliation: Ascension Providence Sports Medicine Fellowship Co Author(s): Nicholas Moore, MD Navin Abro, DO Senior Editor: Raul Rosario-Concepcion, MD Clinical Vignette: An ambidextrous 60 year-old male presents with distal forearm pain and bruising following an injury as he was getting pulled up by a boat to water ski. The patient felt a popping sensation and immediately experienced pain following the injury. He complains of weakness with forearm flexion and supination at the time of examination. Type of Probe Used: 15-6 MHz linear array probe Distal biceps LAX unlabeled Long axis view of the distal attachment site of the biceps tendon (radial tuberosity). Distal biceps LAX labeled Longitudinal view of the distal biceps tendon with associated hematoma Distal biceps LAX unlabeled Long axis view of the affected distal biceps tendon. Distal biceps LAX labeled Absence of distal biceps tendon at radial tuberosity, longitudinal view Distal biceps SAX unlabeled Short axis view of the distal biceps tendon. Distal biceps SAX labeled Retracted biceps tendon bundle surrounded by soft tissue changes Interpretation Image Interpretation: A full-thickness distal biceps tendon tear with tendon retraction and associated hematoma/soft tissue changes. Teaching Pearl: Distal biceps tendon tears typically present with anterior elbow pain, swelling and weakness of elbow flexion and supination. Most of the patients with a full thickness distal biceps rupture report a painful "popping" sensation during the traumatic event. Non-operative treatment is recommended for incomplete tears affecting less than 50% of the bicep tendon. Indications for operative intervention are complete distal biceps rupture, symptomatic partial tears of the distal biceps affecting greater than 50% of the bicep tendon thickness and failure of non-operative treatment for partial tears of less than 50% of the tendon. Note in complete ruptures, the operating surgeon will often want to know how far the proximal tendon stump is retracted, thus measuring and recording this is prudent; this was not documented in this case.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

Distal biceps LAX unlabeled

Distal biceps LAX labeled

Distal biceps LAX unlabeled

Distal biceps LAX labeled

Distal biceps SAX unlabeled

Distal biceps SAX labeled

Interpretation

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