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| IMAGE QUIZ ARCHIVE | ||||||
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Image Quiz Trauma to the Elbow Caused by Lifting1 | ||||||||||
| A sixty-seven-year-old right-hand-dominant retired machinist presented with a one-week history of swelling, mild tenderness, and intermittent erythema in the left elbow. He also had an intermittent burning sensation. He reported no previous problems with the elbow, but he stated that he had lifted a heavy nativity scene at his church the day before the swelling was noticed. | ||||||||||
| The review of systems was otherwise negative. | ||||||||||
| On physical examination, there was a firm, mobile mass measuring 3 × 5 cm on the ulnar side of the distal aspect of the arm, at the level of the epicondyles. The ulnar aspect of the mass appeared to pulsate, although the remainder of the mass did not. Neurovascular examination revealed a 2+ radial pulse and a 1+ ulnar pulse. No sensory deficits were noted; motor examination showed a strength of 5 of 5 throughout, except for flexion and supination of the elbow, which were rated 4 of 5. Resisted elbow flexion and supination were not limited by pain. | ||||||||||
 Fig. 1 For larger view click on image | Plain radiographs of the left elbow revealed no osseous abnormalities. A magnetic resonance image, made without contrast medium, demonstrated a linear defect (ventral to dorsal) in the distal brachialis muscle with decreased signal on T1 and T2-weighted images (Fig. 1). | |||||||||
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What is the diagnosis? | ||||||||||
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