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Distal biceps tendon rupture

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

One day of left elbow pain and restricted movement. Bodybuilder with history of anabolic steroid abuse.

Patient Data

Age: 25 years
Gender: Male
ultrasound

The left side reveals non-visualization of the distal biceps tendon at the elbow. There is a fluid collection at the expected tendon tract at the elbow. The retracted tendon is 50 mm away from its expected insertion site. There is no bony avulsion from the radius or tendon stump attached to the radius. The long head of the biceps tendon is intact in the bicipital groove.

The right biceps distal tendon is intact.

Photo

Surgery revealed a completely torn and retracted distal biceps tendon. The tendon was anchored to its site of insertion at the radius.

PostOp 2 mth US

ultrasound

The repaired biceps tendon reaches to its distal insertion site. A suture are seen around the tendon. An anchor artefact is present at the tendon insertion site. The repaired tendon appears thick and shows a heterogeneous echopattern which is a normal post operative finding.There is no local collection. There is no effusion in the anterior recess of the elbow joint.

Case Discussion

A young man involved in bodybuilding with a history of steroid abuse presented with left elbow pain following a workout. Ultrasonography revealed a complete tear of the distal biceps tendon. MRI (although not uploaded) showed similar findings. A surgical repair was performed.

Intra-operative photos courtesy of operating surgeon: Dr Ritesh Patel

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