Persistent Anterior Elbow Pain Caused by a Partial Distal Biceps Tendon Tear With Bicipitoradial Bursitis: A Case Report

Partial distal biceps tendon tears are an uncommon cause of anterior elbow pain and can be difficult to diagnose because physical examination findings may be nonspecific and MRI has limited sensitivity for partial tears.We report the case of a 47-year-old right-hand-dominant man who developed sudden right elbow pain while readjusting a cardboard box.Although his range of motion improved with conservative treatment, pain during forearm supination and elbow flexion persisted and prevented him from returning to work.The MRI demonstrated bicipitoradial bursitis and partial discontinuity of the distal biceps tendon.Because of persistent symptoms and the substantial impact on his ability to work, surgery was selected after discussion of both continued conservative management and surgical treatment with the patient.Intraoperatively, fluid was noted within the bicipitoradial bursa, and an approximately 50% partial tear of the distal biceps tendon was identified after excision of the bursa.The tendon was repaired using two suture anchors.The patient returned to work with activity restrictions six weeks after surgery.At approximately 2.5 years postoperatively, he reported no pain or functional limitations, although mild discomfort occasionally occurred when lifting heavy objects.This case highlights the importance of considering a partial distal biceps tendon tear in patients with a clearly defined onset of anterior elbow pain and of integrating the clinical history, physical examination findings, and MRI findings when establishing the diagnosis.