What does a triceps tendon tear look like on ultrasound?

What do injuries of the triceps tendon look like with ultrasound imaging? The top image shows the distal triceps tendon with tendinosis at its attachment on the proximal ulna (the olecranon process). The distal tendon is thickened with a loss of normal fibrous echotexture. There is hypoechogenicity (darkening) of the superficial layer of the conjoined tendon (white arrow) compared to the deep portion (orange arrow) and a loss of the normal tendon tapering conformity at the insertion on the olecranon.

The bottom image shows a selective area of complete fiber non-visualization of the distal triceps tendon’s superficial portion near its insertion on the olecranon (white arrow), demonstrating a high-grade partial tendon avulsion/tear. Note that the deep fibers of the medial triceps head (orange arrow) are preserved, which is common for this injury.

Reference: Chorba RS, Hu CG, Feldtmann JJ. Triceps Tendon Avulsion in a Soldier: A Case Report. Int J Sports Phys Ther. 2024;19(5):618-624. doi:10.26603/001c.116276

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