Also known as bicepitoradial bursitis
Rare painful condition of elbow
Anatomy:
2 bursae in the anterior elbow joint.
1. Bicipitoradial (cubital) bursa: Cubital bursa is seen between distal biceps tendon and anterior part of radial tuberosity, tracks along medial cortex of radius and wraps around distal biceps tendon. The biceps tendon inserts into the rough posterior area of the bicipital tuberosity, and bicepitoradial bursa separates it from the smooth anterior area of the tuberosity. Compressed in pronation Usually not seen on US or MR
2. Interosseous medial bursa: present in 20%, adjacent to biceps along the brachialis; may compress median nerve
Both may communicate with each other
Etiology:
Due due repitative supination and pronation mechanical injury
Trauma, RA, CPPD, PVNS, infection, synovial chondromatosis, chemical synovitis, bone proliferation/spur
Associated with tear
Clinical features:
Painful swelling in the antecubital fossa, loss of motion, locking
Crepitation, palpable loose bodies
Can cause compression on the median or posterior interosseous nerve
Ultrasound:
7.5-12 MHz
Power Doppler assesses the degree of inflammation
Bursitis is seen as anechoic/ hypoechoic lesion with/without echogenic debris/ calcifications wrapping the biceps tendon and superficial to it
Distal biceps tendon is usually intact
Can be treated with ultrasound guided aspiration (22G) and injecting 2 mL of 1% lignocaine (25%); 0.5% bupivacaine (25%) and triamcinolone (40 mg/mL) (Kenalogis) (50%) is injected
MRI:
Better anatomical details
References:
1. Sofka CM et al. Sonography of cubital bursitis. AJR 2004; 183:51-53
2. Matsumoto K et al. Cubital Bursitis Caused by Localized Synovial Chondromatosis of the Elbow. A Case Report. The Journal of Bone and Joint Surgery 78:275-7 (1996)
3. Chew ML et al. Disorders of the Distal Biceps Brachii Tendon. RadioGraphics 2005;25:1227-1237
