Bilateral snapping triceps syndrome: A case report

Abstract

BACKGROUND

Snapping triceps syndrome (STS) is a rare disease, while occurrence of bilateral STS is extremely rare. It is usually accompanied by dislocation of the ulnar nerve and double snapping is a clinically important feature. However, to the best of our knowledge, there has been no report of bilateral STS in young active patient.

CASE SUMMARY

A 23-year-old male presented with a complaint of discomfort and snapping on the medial side of both elbows while performing push-ups. On physical examination, two distinct snaps that were both palpable and audible were detected on additional clinical examination. Dynamic ultrasonography showed that the ulnar nerve and the medial head of the triceps were dislocated anteriorly over the medial epicondyle of the elbow during flexion motion. Finally, he was diagnosed as dislocation of the ulnar nerve and STS. Staged anterior subcutaneous transposition of the ulnar nerve combined with partial resection of the snapping portion of the triceps was performed. The patient’s pain and snapping symptoms were resolved immediately after surgery. Three months later, the patient was completely asymptomatic and returned to normal activity.

CONCLUSION

STS should be included in the differential diagnosis for active young patients who present with painful snapping on the medial side of the elbow joint, particularly when dislocation of the ulnar nerve is detected. Dynamic sonography is used to assist in accurate diagnosis and differentiation between isolated dislocation of the ulnar nerve and STS.

Keywords: Triceps; Triceps snapping syndrome; Ulnar nerve; Elbow; Dynamic sonography; Case report

Core Tip: Snapping triceps syndrome (STS) is a rare disease, while occurrence of bilateral STS is extremely rare. It is usually accompanied by dislocation of the ulnar nerve and double snapping is a clinically important feature. Dislocation of the ulnar nerve typically occurs first, at approximately 70 to 90 degrees of elbow flexion, followed by dislocation of the triceps at approximately 100 to 110 degrees of elbow flexion. Dynamic sonography is used to assist in accurate diagnosis and differentiation. Here we reported on the case of a patient who underwent surgery for treatment of bilateral STS.