Snapping triceps syndrome
Post-traumatic right elbow pain on medial aspect for last few days.
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With elbow extension, the ulnar nerve is anterior to the medial epicondyle of the humerus. Nerve shows normal caliber and echopattern. With elbow flexion, ulnar nerve moves more anteriorly to the medial epicondyle. There is also triceps muscle dislocation anterior to the medial epicondyle of the humerus with the elbow flexion. Snapping could be felt due to triceps dislocation with elbow flexion.
There is no elbow effusion. Common flexure tendon, common extensor tendon, biceps distal tendon, medial ( ulnar ) collateral ligament show normal echopattern.
Adult male presented with medial elbow trauma with pain. Ultrasound shows ulnar nerve anterior to the medial epicondyle of the humerus with elbow extension meaning dislocated ulnar nerve. With elbow flexion, there is triceps dislocation anterior to the medial epicondyle of the humerus. Only one 'snap' could be felt that was due to triceps dislocation. Patient's symptoms were not related to snapping of triceps. Rest of the elbow ultrasound examination was normal.
The case is an asymptomatic/unrecognized snapping triceps syndrome.
- Ultrasound of the Musculoskeletal System. S. Bianchi & C. Martinoli. 1st Indian Reprint 2007.