Disclosures: Shrut Patel, MD: Nothing to disclose

Case Description: A 61-year-old male initially presented to an urgent care facility with left elbow pain, erythema, swelling, and a comorbid open wound secondary to minor trauma. He was prescribed doxycycline and indomethacin for presumed management of cellulitis and gout which did resolve his symptoms. His symptoms resurfaced following a golfing event, prompting a second urgent care visit. He was prescribed bactrim, naproxen, and colchicine with mild benefit. Subsequent evaluation at our sports medicine clinic revealed 4/5 strength for elbow extension, and elbow swelling. Point-of-care ultrasonography was concerning for triceps tendon tear. Follow-up non-contrast MRI confirmed partial triceps tendon tearing at the ulnar insertion with periosteal avulsion. He was referred to orthopedic surgery and underwent surgical repair. Therapy was recommended following a period of post-operative immobilization.

Setting: Academic Outpatient Sports Medicine Clinic

Patient: 61-year-old male with left elbow pain.

Assessment/Results: Triceps tendon tear identified on musculoskeletal ultrasound and confirmed with MRI.

Discussion: Triceps tendon ruptures and avulsion injuries are rare conditions, accounting for <1% of upper extremity tendon injuries. The most common mechanism for these injuries is forceful eccentric contraction. This case presented an injury that stemmed from minor trauma. The initial wound and symptoms misled clinicians into treating presumed infection and gout. This case further highlights utility of point-of-care ultrasound.

Conclusion: We present an atypical case of triceps tendon rupture with an uncommon mechanism of injury masquerading as presumed cellulitis and gout. Despite its rarity, the diagnosis of triceps tendon tear should be considered in a differential for elbow-related pathology. Point-of-care ultrasonography should be considered as an extension of the physical exam.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/atypical-presentation-of-partial-triceps-tendon-tear-with-periosteal-avulsion-masquerading-as-cellulitis-and-gout-a-case-report/