Virginia Research Day 2025

Medical Resident Research Case Reports

01 Arm Pain in a College Football Player

Colleen Bannigan, DO; Mason Nelson, OMSII; Matthew Chung, DO; Cristofer Catterson, MD; Zack Maust, MS, LAT, ATC; Reagan Ratcliffe MS, LAT, ATC Corresponding author: cbannigan01@vcom.edu

Virginia Tech Sports Medicine Department, Blacksburg, VA

extension. He denied numbness or tingling. Physical examination revealed swelling and tenderness in left distal triceps. There was no tenderness to bony features of olecranon, medial condyle, or lateral condyle. Notably, the patient demonstrated full strength with resisted elbow flexion but was unable to perform resisted elbow extension secondary to pain. Sideline X-rays did not reveal any obvious fracture or dislocation. Ultrasound imaging following the game demonstrated an obvious defect suspicious for a triceps tear. Given functional disability, an MRI was performed which showed a 20cm longitudinal tear of the entire triceps tendon down to the olecranon insertion with approximately 2cm retraction at the distal insertion. Given ultrasound and MRI findings, the patient successfully underwent an open repair of the triceps tendon. He was placed in a locked hinge

elbow brace at 60 degrees. He has progressed nicely from a rehab perspective and is expected to make a full recovery. Discussion: This case highlights the value of ultrasound as an acute diagnostic tool to provide a rapid, portable, cost-effective method for evaluation of soft tissue injury. While MRI is the gold standard for diagnosis of soft tissue injury, ultrasound can be valuable during initial assessment or when MRI is not available, particularly in the setting of sports. The diagnostic clues revealed during ultrasound imaging can expedite diagnosis and treatment, aiding in assessment of whether an athlete can immediately return to play or if the injury requires more evaluation and intervention. Further research is needed to establish protocol for use of ultrasound in the initial evaluation of soft tissue injuries.

Introduction: Triceps tears in the general population are rare accounting for 0.8% of tendon ruptures and occur more frequently in sports with forceful eccentric loads such as football and weightlifting. Triceps ruptures can be diagnosed clinically; however, MRI can be used to determine location and severity. Diagnostic ultrasound is a rapid, low-cost diagnostic imaging method that may aid in diagnosis evaluation of the severity of injury. The application of ultrasound in diagnosing triceps ruptures has limited research due to the injury’s low prevalence. Case Presentation: A twenty-one-year-old male college football player sustained an injury during a game that involved forceful extension. No prior injury to the arm and noted most of his pain to the posterior elbow and upper arm and pain with elbow

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