Elbow (Minor)

Biceps Tendon Rupture

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 and may produce mid-arm "ball"
• 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

Diagnosis

• Obtain radiographs to rule-out avulsion fracture

Management

• Sling, ice, and referral to ortho
  • Surgical repair is usual for young, active pts

Triceps Tendon Rupture

Background

• Injury is rare and almost always occurs distally
• Results from FOOSH causing flexion of extended elbow or direct blow to olecranon

Clinical Features

• Pain and swelling posteriorly just proximal to the olecranon
• Sulcus w/ a more proximal mass (retracted triceps) may be palpated
• With complete rupture ability to extend the elbow is lost

Diagnosis

• Obtain radiographs to rule-out avulsion fracture

Management

• Sling, ice, and referral to ortho
• Most partial tears can be treated conservatively w/ immobilization

Lateral Epicondylitis (Tennis Elbow)

Background

• Overuse syndrome affecting the forearm, wrist, and digit extensors/supinators

Clinical Features

• TTP over the lateral epicondyle and pain w/ forced extension and supination of forearm

Management

• Conservative: rest, ice, NSAIDs, immobilization (often via counterforce brace)

Medial Epicondylitis (Golfer's Elbow)

Background

• Overuse syndrome affecting the wrist and digit flexors
• Also seen in pitchers and rock-climbers

Clinical Features

• TTP over medial epicondyle and pain w/ forced flexion and pronation of forearm/wrist
• Ulnar neuropathy may develop (given proximity of ulnar nerve to medial epicondyle)

Management

• Conservative: rest, ice, NSAIDs, immobilization (often via counterforce brace)

Olecranon Bursitis

Injury:

Diag: Swelling; FROM; ?aspirate

Rx: Avoid trauma and excessive pressure; chronic = surg

See Also

• Elbow Fracture

Source

• Tintinalli