MRI of the Brachialis Tendon Insertion

Elbow MRI Brachialis tendon tendinosis and tears.

The Brachialis tendon is less commonly injured than the biceps.  It inserts onto the anterior ulnar on the ulnar tuberosity and to a lesser extent on the coronoid process but the tendon is very short compared to the biceps tendon. Most commonly we see tendinosis or a strain/ partial tear at the musical tendinous junction. Complete ruptures are uncommon.

Image Above: Location of insertion of brachialis tendon. ( Image credit First Image  Bartleby.com: Gray’s Anatomy, Plate 213, 2nd Image Source unknown please inform us if this is yours and we will acknowledge)

Image Above: Normal Brachialis tendon ( blue arrow). Should be black on all sequences like all tendons. Second image sagittal scan, broad tendon attachment ( blue arrow) with a very short tendon length. Brachialis muscle ( red arrow). Biceps tendon ( yellow arrow). 

Image above: Brachialis tendinosis standard appearance of tendinosis in any tendon with increased PDFS signal in tendon and peritendinous oedema ( blue arrow). Mild tendinosis biceps tendon ( yellow arrow). 

Image above: Brachialis tendon ( yellow arrow) barely seen due to  tendinosis and delamination. Compare signal with normal biceps tendon ( blue arrow). 

Image Above: Brachialis musculotendinous junction ( MTJ) strain and partial tearing. Oedema in muscle at MTJ ( blue arrow). Brachialis tendon ( yellow arrow) appears normal. 

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