A brachialis muscle rupture diagnosed by ultrasound; case….pdfVIP

Schönberger and Ernst International Journal of Emergency Medicine 2011, 4:46 /content/4/1/46 CASE REPORT Open Access A brachialis muscle rupture diagnosed by ultrasound; case report Titus JA Schönberger 1*† and Miranda F Ernst2† Abstract Trauma to the elbow caused by lifting heavy objects frequently involves rupture of the tendon of the biceps brachii muscle. Less frequently a rupture of the brachialis muscle occurs. To our knowledge, only five cases involving traumatic rupture of the brachialis muscle were described in the past 20 years. We will briefly report these cases. To demonstrate and evaluate muscle injuries, magnetic resonance imaging (MRI) is considered the most sensitive and specific method of choice. We report an isolated brachialis muscle rupture caused by resisted flexion and pronation of the lower arm. Physical examination combined with ultrasound evaluation confirmed the diagnosis of ruptured brachialis muscle. Treatment was non-operative with full restoration of function. Background paresthesias of the left upper extremity. The patient Trauma to the elbow caused by lifting heavy objects fre- denied the use of medication, drugs or food supplements, quently involves rupture of the tendon of the biceps bra- and denied smoking or excessive alcohol use as well. chii muscle. Less frequently a rupture of the brachialis On physical examination, maximum pain was elicited muscle occurs. After an extensive online search, we found on active flexion and pronation of the lower arm. Pas- only five cases involving traumatic rupture of the brachia- sive extension and resisted flexion of the elbow lis muscle had been described in the past 20 years. To