Snapping Elbow Syndrome
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Introduction[edit | edit source]
Snapping elbow syndrome, also known as snapping tricep syndrome, is a rare condition characterised by a snapping sensation, and symptoms related to irritation or subluxation of the ulnar nerve at the cubital tunnel, or pain and inflammation from a dislocating triceps segment[1][2]. It is a dynamic condition occurring during either elbow flexion or extension with a snap on both active and passive movement[2]. Dislocation of the triceps tendon may happen over either the medial or the lateral epicondyle, however it occurs far more commonly over the medial one[3].
Snapping elbow syndrome occurs at a mean age of 32 years (n = 30), ranging from 14-65 years with a male to female ratio of 6.5:1[4].
Clinical presentation[edit | edit source]
- Snapping is audible, palpable, and usually visible[5].
- Can have elbow pain or ulna neuropathy if dislocating medially[2]
- Can be asymptomatic[6]
- Snapping triceps can present bilaterally, but may not be symptomatic on both sides[7]
Diagnostic tools[edit | edit source]
Ultrasound is the tool of choice due to its dynamic nature and ability to differentiate between a snapping triceps tendon or ulna nerve[8].
Spinner (2002) postulated that a snapping ulna nerve and snapping triceps could be differentiated by the angle at which the snapping occurred - the ulna nerve is thought to snap at 70-90 degrees of flexion, whereas the triceps is thought to snap at around 115 degrees of flexion[2].
Treatment[edit | edit source]
It is useful to distinguish between lateral and medial tricep dislocation, as pathology, diagnostic strategy and treatment are different in the two situations[5].
References[edit | edit source]
- ↑ Rioux-Forker D, Bridgeman J, Brogan DM. Snapping Triceps Syndrome. The Journal of hand surgery (American ed). 2018;43(1):90.e1–90.e5.
- ↑ 2.0 2.1 2.2 2.3 Spinner RJ, Goldner RD. Snapping of the medial head of the triceps: diagnosis and treatment. Techniques in Hand & Upper Extremity Surgery. 2002 Jun 1;6(2):91-7.
- ↑ Spinner RJ, Goldner RD, Fada RA, Sotereanos DG. Snapping of the triceps tendon over the lateral epicondyle. The Journal of hand surgery. 1999 Mar 1;24(2):381-5.
- ↑ Shuttlewood K, Beazley J, Smith CD. Distal triceps injuries (including snapping triceps): A systematic review of the literature. World J Orthop. 2017 Jun 18;8(6):507-513. doi: 10.5312/wjo.v8.i6.507. PMID: 28660143; PMCID: PMC5478494.
- ↑ 5.0 5.1 Bjerre JJ, Johannsen FE, Rathcke M, Krogsgaard MR. Snapping elbow-A guide to diagnosis and treatment. World J Orthop. 2018 Apr 18;9(4):65-71. doi: 10.5312/wjo.v9.i4.65. PMID: 29686971; PMCID: PMC5908985.
- ↑ Spinner RJ, An KN, Kim KJ, Goldner RD, O'Driscoll SW. Medial or lateral dislocation (snapping) of a portion of the distal triceps: a biomechanical, anatomic explanation. Journal of shoulder and elbow surgery. Spinner RJ, An KN, Kim KJ, Goldner RD, O'Driscoll SW. Medial or lateral dislocation (snapping) of a portion of the distal triceps: a biomechanical, anatomic explanation. Journal of shoulder and elbow surgery. 2001 Nov 1;10(6):561-7.|2001 Nov 1;10(6):561-7.
- ↑ Spinner RJ, Goldner RD. Snapping of the medial head of the triceps and recurrent dislocation of the ulnar nerve. Anatomical and dynamic factors. JBJS. 1998 Feb 1;80(2):239-47.
- ↑ Chuang HJ, Hsiao MY, Wu CH, Özçakar L. Dynamic ultrasound imaging for ulnar nerve subluxation and snapping triceps syndrome. American Journal of Physical Medicine & Rehabilitation. 2016 Jul 1;95(7):e113-4.
