This is Barry Bellosis, one of the musculoskeletal radiology fellows at Stanford University. The patient in this case presented with bilateral AP and lateral elbow radiograph, which are normal. This is often the case in the setting of bicep stent and tear. In some cases we can see some edema, but in this specific case we have a normal radiograph. The patient then underwent MRI. This patient's MRI without contrast showed the sagittal t2 fat saturated images with edema signal at the course of the bicep stent, which is around this region. There's no bicep stent and visualize consistent with bicep stent and tear. To visualize this, this is in a different patient, a 50 year old male with arm pain. In this patient we have axial t2 fat sat imaging at the level of the radial tuberosity. In this location we should expect a hypo intense or dark line inserting at the radial tuberosity, which is the bicep stent. We go proximally, we still don't see it, and at the level of the elbow joint we just see a lot of fluid and edema, and at the level of the distal humerus we can see this hypo intense band surrounded with large fluid, likely a hematoma, consistent with retracted bicep stent. In our sagittal t2 fat sat imaging, this is better depicted showing this hypo intense curvilinear line, which is a retracted bicep stent with surrounding hematoma and edema consistent with bicep stent and tear. This is a comparison showing a normal bicep stent and inserting at the radial tuberosity. We can see this hypo intense band, which is normal. This is the case that we just saw, showing edema signal without the hypo intense band at the expected location of the radial tuberosity.

2nd Edition, CASE 07

2nd Edition

Elbow and Forearm

biceps tendon tear

MRI

edema

radiology

elbow x-rays