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 acute distal right 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 complained of weakness with forearm flexion and supination at the time of examination. Type of Probe Used: 15-6 MHz linear array Unlabeled Long Axis View of the Distal Biceps Tendon Insertion Unlabeled Long Axis View of the Distal Biceps Tendon Insertion Labeled Long Axis View of the Distal Biceps Tendon Insertion Labeled Long Axis View of the Distal Biceps Tendon Insertion with complete absence of distal biceps tendon at radial tuberosity Unlabeled Long Axis View of the Distal Biceps Tendon Unlabeled Long Axis View of the Distal Biceps Tendon Labeled Long Axis View of the Distal Biceps Tendon Labeled Long Axis View of the retracted Distal Biceps Tendon with associated hematoma Unlabeled Short Axis View of the Distal Biceps Tendon Unlabeled Short Axis View of the Distal Biceps Tendon Labeled Short Axis View of the Distal Biceps Tendon Labeled Short Axis View of the retracted Distal Biceps Tendon surrounded by soft tissue changes Interpretation Image Interpretation: Full-thickness distal right 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, bruising, and weakness of supination more than flexion (flexion is often preserved by the brachialis and brachioradialis), often after a painful pop. Ultrasound can demonstrate full-thickness tendon discontinuity, retraction, hematoma, and whether the lacertus fibrosus remains intact. Nonoperative treatment may be reasonable for selected low-demand patients, but complete rupture in an active patient often warrants timely surgical discussion. Delayed diagnosis can make repair more difficult. References: 1. Al-Ani Z, Lauder J. Ultrasound assessment in distal biceps tendon injuries: techniques, pearls and pitfalls. Clin Imaging. 2021;75:46-54. doi:10.1016/j.clinimag.2021.01.017 2. de la Fuente J, Blasi M, Martínez S, et al. Ultrasound classification of traumatic distal biceps brachii tendon injuries. Skeletal Radiol. 2018;47(4):519-532. doi:10.1007/s00256-017-2816-1 3. Jaschke M, Rekawek K, Sokolowski S, Kolodziej L. Distal biceps tendon rupture: a comprehensive overview. EFORT Open Rev. 2023;8(11):865-873. doi:10.1530/EOR-23-0035
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Authors, Editors, Case Information

Unlabeled Long Axis View of the Distal Biceps Tendon Insertion

Labeled Long Axis View of the Distal Biceps Tendon Insertion

Unlabeled Long Axis View of the Distal Biceps Tendon

Labeled Long Axis View of the Distal Biceps Tendon

Unlabeled Short Axis View of the Distal Biceps Tendon

Labeled Short Axis View of the Distal Biceps Tendon

Interpretation

UPCOMING EVENTS

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