Weekly Case

Title : case 149

Age / Sex : 58 / M


Age / Sex : 58/M


Chief complaint :


post. elbow pain during golf swing 2 Months ago.



1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

* Send Application Answers to In Sook Lee, MD (lis@pusan.ac.kr)

Courtesy:


Diagnosis:

triceps tendon tear



Discussion


Findings:


Bony fragments in post. aspect of distal humeral diaphysis with soft tissue swelling at post. elbow on radiograph


T2WI MR revealed retracted torn triceps tendon with a fleck of bone embedded in it.


 


Differential Diagnosis:


 


Diagnosis:  


Triceps avulsion fx. 


(triceps tendon tear with avulsion from olecranon)


 


Discussion:


 The mechanism of injury in triceps tendon rupture usually involves forced flexion of the elbow against the resistance of contracting triceps muscle, which most commonly occurs during a fall on an outstretched arm. In addition, rupture of triceps tendon may also occur secondary to a direct blow, extreme concentric contraction during weight-lifting.


MR appearance includes discontinuity of tendon, retracted tendon, fluid gap in torn portion, and avulsion of tendo-osseous attachment.


Treatment spans from conservative management (rest, ice, temporary splinting) from repair or reconstruction.


 


References:


D.W. Stoller. MR imaging in orthopaedics and sports medicine 3rd Ed.



Correct Answer
Name Institution
total applicants 6
correct answer 3
채지원 : 보라매병원
박희진 : 명지병원
김혜린 (전공의) : 순천향대학병원
semi-correct answer 2
박은태 (전공의) 고려대 구로병원
김완태 서울보훈병원

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