Findings
Sagittal reformatted CT, sagittal PDFS & T2, coronal PDFS images reveal complete avulsion fracture of posterior component (long and lateral heads) of distal triceps tendon near insertion site at olecranon with proximal retraction of fibers. Exposed surface of olecranon process from which the posterior component of distal triceps tendon has been avulsed was noted. Anterior or deep muscular component (medial head) of distal triceps tendon is normal. Edema is seen in soft tissues adjacent to the tendon tear.
Diagnosis
Complete avulsion fracture of posterior component of distal triceps tendon with intact anterior component.
Summary
Distal triceps tendon tears are nearly always avulsions at the tendon bone interface. The intact tendinous portion of the anterior component (green arrowhead) may simulate an untorn tendon particularly if the posterior component is not well seen or is retracted above the imaged area. Reporting radiologist should search for the uncovered footprint of the posterior component and soft tissue hematoma or injury posterior to olecranon so that torn posterior component of distal triceps tendon won’t be missed.
Further reads
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