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25b - Answer: 31-year-old male presents with sharp, burning pain in right elbow

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 31-year-old male presents with moderate constant sharp, burning pain in right elbow since work injury. History of scrap metal hitting elbow. Difficulty with lifting arm, objects, and throwing. Weakness, swelling, and discoloration.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

All of the above.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

No acute bony macrofracture or contusion. Ulnar collateral and radial collateral ligament complexes intact. Nominal chronic tendinopathy of common extensor tendon; no tear. Common flexor tendon intact. Biceps tendon intact. Strained distal triceps tendon; no tear. Grade 2 strain of distal triceps muscle with a 2.5 x 3 x 0.7cm intramuscular hematoma. A muscle defect in the medial head adjacent to tendon coalescence of lateral and long heads residing 6cm above the capitellum is 40 percent in the transverse dimension and at least 50 percent depth.

Ulnar nerve normal in caliber. 

IMPRESSION:

Right Elbow: Acute grade 2-3 strain of distal triceps muscle with intramuscular hematoma. 

Nominal chronic tendinopathy of common extensor tendon. No tear. 

LESSON 2, TOPIC 75

Case Challenge: Elbow MRI Cases

Case Challenge

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Content reviewed: October 28, 2021

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