HSS Ultrasound of the Month Case #104

Clinical History 20 year old male with inability to extend the thumb three months after fracture of the distal radius treated conservatively.

Ultrasound evaluation of the extensor pollicis longus (EPL) tendon was requested.

Ultrasound of the Month – Case 104

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Ultrasound of the Month – Case 104

Ultrasound of the Month – Case 104

Diagnosis: Tendon rupture of EPL Discussion EPL rupture is a common complication after fracture of the distal radius.

Fracture of the distal radius often goes through Lister’s tubercle, and since the EPL courses adjacent to Lister’s tubercle, this tendon is vulnerable to irritation and eventual tear if the fracture results in an irregular contour or jagged edge along Lister’s tubercle.

Because the EPL, along with all other tendons of the wrist, lies relatively superficial, they are well evaluated on ultrasound.

Even before frank rupture, fraying of the tendon and fluid in the tendon sheath are signs of irritation.

Ultrasound of the Month – Case 104

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