Biceps tendon rupture
Revision as of 08:17, 31 January 2015 by Rossdonaldson1 (talk | contribs)
Background
- Vast majority are proximal
- Occurs w/ sudden or prolonged contraction in pt w/ chronic bicipital tenosynovitis
Clinical Features
- Snap or pop is described
- Flexion of elbow elicits pain
- May produce mid-arm "ball" but difficult in obese patients
- Loss of strength is minimal
- Proximal
- Swelling and tenderness over bicipital groove
- Distal
- Swelling and tenderness over antecubital fossa
- Inability to palpate distal biceps tendon in antecubital fossa
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Diagnosis
- Obtain radiographs to rule-out avulsion fracture
- Ultrasound can help with diagnosis
Management
- Sling, ice, NSAIDS, and referral to ortho
- Surgical repair is usual for young, active pts