Rupture of the triceps tendon is a rare injury. Triceps tendon rupture occurs in both males and females and in individuals of all ages. Rupture of the triceps tendon is almost always the result of a single traumatic event. The mechanism of injury usually is a fall on an outstretched hand. Less common mechanisms of injury include a direct blow to the posterior elbow and a forceful eccentric contraction of the triceps muscle with the elbow flexed. Most tears of the triceps tendon occur at the insertion site of the tendon into the olecranon process of the proximal ulna. Intrasubstance tears and tears at the musculotendinous junction of the triceps tendon have been reported but are rare [63-70].
MRI can be used to evaluate individuals with triceps tendon rupture. MRI can distinguish between partial and complete rupture of the triceps tendon and can determine the amount of retraction of a completely torn tendon.
Fig. 18. Complete biceps tendon rupture in a 52-year-old male with anterior elbow pain following trauma. (A) Axial fat-suppressed T2-weighted fast spin-echo image of the elbow shows absence of the distal biceps tendon and fluid adjacent to the radial tuberosity (arrowhead). (B) Axial fat-suppressed T2-weighted fast spin-echo image of the elbow proximal to the previous image shows the retracted completely torn biceps tendon (arrowhead) with surrounding soft tissue edema within the antecubital fossa (arrows). (C) Sagittal fat-suppressed T2-weighted fast spin-echo image of the elbow better visualizes the extent of retraction of the completely torn biceps tendon (arrowhead) and the degree of soft tissue edema within the antecubital fossa (arrow).
The triceps tendon is visualized best on sagittal MRI images. Partial tendon rupture is characterized by a small fluid-filled defect within the distal triceps tendon and edema within the surrounding subcutaneous tissue. Complete rupture of the triceps tendon is characterized by a large fluid-filled gap between the distal triceps tendon and the olecranon process and a large amount of edema within the surrounding subcutaneous tissue. A variable amount of retraction of the completely torn distal triceps tendon usually is present (Fig. 19) [71,72].
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