IB mm

FIGURE 4.11. Radiographically occult type I fracture of the coronoid process in a patient with pain and loss of motion after a fall. A T2*-weighted gradient-echo sagittal image reveals a nondisplaced sheer fracture of the coronoid process (white arrows). An effusion and foci of thickened synovium (black arrows) are also noted. The synovial thickening should not be mistaken for small loose bodies on these images.

FIGURE 4.12. Cubital bursitis, tendinosis, and intrasubstance partial tearing of the distal biceps tendon. Proton-density (A) and T2-weighted (B) axial images reveal prominent distention of the bicipital radial bursa (curved arrows). The bursa separates the biceps tendon from the radial tuberosity further distally. Moderate increased signal is seen in the biceps tendon on the proton-density image (straight white arrow) consistent with degenerative tendinosis. A small longitudinal split (small black arrows) is seen in the medial aspect of the thickened tendon. Partial rupture of the distal biceps and bursitis may be difficult to distinguish clinically and may also coexist.

FIGURE 4.12. Cubital bursitis, tendinosis, and intrasubstance partial tearing of the distal biceps tendon. Proton-density (A) and T2-weighted (B) axial images reveal prominent distention of the bicipital radial bursa (curved arrows). The bursa separates the biceps tendon from the radial tuberosity further distally. Moderate increased signal is seen in the biceps tendon on the proton-density image (straight white arrow) consistent with degenerative tendinosis. A small longitudinal split (small black arrows) is seen in the medial aspect of the thickened tendon. Partial rupture of the distal biceps and bursitis may be difficult to distinguish clinically and may also coexist.

ered less common than complete ruptures of the triceps tendon.55-57

The consequences of overloading the extensor mechanism of the elbow depend largely on the age of the patient and the presence of pre-existing tendon degeneration. Most often, the tendon ruptures at the site of degenerative tendinosis. In skeletally immature individuals, separation of the olecranon growth plate may occur and require internal fixation. Acute overload of the extensor mechanism in an adolescent with a partially closed ole-cranon growth plate may result in a Salter-Harris type II fracture that may be radiographically subtle. MRI may be useful in this setting to evaluate the extensor mechanism and detect occult injury to the growth plate.

Injuries of the triceps tendon and muscle are well seen with MRI.6,58,59 The normal triceps tendon often appears lax and redundant when the elbow is imaged in full extension or mild hyperextension. This appearance resolves when the elbow is imaged in mild degrees of flexion and should not be mistaken for an abnormality. Degenerative tendinosis is characterized by thickening and signal alteration of the distal tendon fibers. Acute rupture is well seen on T2-weighted or STIR images due to surrounding fluid. Partial tears are much less common than complete rupture and are more difficult to diagnose clinically.60

MRI can distinguish between complete tears that require surgery and partial tears that may do well with protection and rehabilitation. MRI also can help delineate the degree of tendon retraction and muscular atrophy that is present when rupture of the triceps has been missed and a more extensive reconstruction of the defect is required.

Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

Get My Free Ebook


Post a comment