Distal Biceps Tendon Tear (DBTT)

EXPLORE MORE DIAGNOSES View Key Images View Key Images Watch Video Watch Video Review Stacks Review Stacks
  • Most biceps tendon ruptures are proximal at the shoulder; distal biceps tendon tears (DBTT) at the elbow account for 3-5% of biceps injuries
  • DBTT can occur in football players and weightlifters, at or near the tendon’s insertion onto the radial tuberosity resulting from forced hyperextension of flexed and supinated arm
  • MR imaging is performed in the axial plane with the arm extended, and in the longitudinal plane with the patient lying prone with the arm overhead, the elbow flexed to 90°, and the forearm supinated, so that the thumb points superiorly (FABS—flexed elbow, abducted shoulder, forearm supinated)
  • In complete tears, MRI shows discontinuity with or without retraction (best seen on longitudinal FABS); the proximal tendon is enlarged with high signal
  • Partial tears are seen as an increase in caliber and abnormal contour with high intratendinous signal
  • High signal T2 peritendinous fluid (edema, bursitis, or hemorrhage) may be seen
  • If the bicipital aponeurosis is intact (best seen on axial view), there may be no tendon retraction
  1. Alentorn-Geli E, et al. Distal biceps tendon injuries: a clinically relevant current concepts review. EFORT Open Reviews 2016; 1:316-324.
  2. Chew ML, Giuffre BM. Disorders of the distal biceps brachii tendon. RadioGraphics 2005; 25:1227-1237.
  3. Pomeranz SJ, et al. Category B: Elbow. Gamuts & Pearls in MRI & Orthopedics. 1997; P. 60
  4. Sonin AH, et al. MR Imaging of Sports Injuries in the Adult Elbow. American Journal of Roentgenology 1996; 167(327):325-331.

Related Cases


49-year-old male anterior elbow pain

Musculoskeletal (MSK), Biceps tendon tear,

Start Your
Membership Today!

Learn from our world renowned faculty.



Mastery Video Courses


Scrollable Cases and Reports


CME Available

Free Trial

Try it free for 7 days

All delivered in micro-learning modules to help
you get straight to learning