Biceps Tendon Rupture at the Radial Tuberosity

Drs Turkel, Lomasney, and Demos are from the Department of Radiology and Dr Marra is from the Department of Orthopedics, Loyola University Medical Center, Maywood, Illinois. Drs Turkel, Lomasney, Demos, and Marra have no fi nancial relationship to disclose. Correspondence should be addressed to: Terrence C. Demos, MD, Dept of Radiology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153. The sagittal T2-weighted magnetic resonance image (MRI) in Figure 1 shows complete disruption of the distal biceps tendon with 3.5cm retraction proximal to the radial tuberosity attachment. A small high T2-signal fl uid collection is present in the tendon gap with regional edema, but no hematoma (Figure 1). The biceps brachii has complex anatomy including two sites of tendinous origin on the scapula and a single insertion site on the radius. Thus, this muscle-tendon unit contributes to function both at the shoulder girdle and the elbow. Although proximal tendon injuries are relatively common, resulting from a variety of acute and chronic pathologies, distal tendon tears near the radial insertion account for only 3% of biceps tendon injuries.1 However, distal injuries are signifi cant clinically, resulting in loss of elbow supination strength and, to a lesser extent, loss of fl exion strength.