The radial tuberosity is an oval roughened prominence on the medial surface of the proximal radius, approximately 2 cm distal to the radial head, at the junction of the radial neck and shaft. It is the insertion of the distal biceps brachii tendon on its posterior facet (for the tendon) and anterior facet (for the bicipital bursa). The tuberosity rotates between the ulna and the biceps tendon during supination and pronation, creating the mechanical advantage for bicipital supination.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Ossified from the shaft, sometimes with a small secondary centre at about 14-15 years that fuses soon after. |
The radial tuberosity (also called the bicipital tuberosity) is the endpoint of distal biceps tendon reattachment during surgical repair of distal biceps rupture, using suture anchors, cortical buttons or bone tunnels. Anatomic reattachment to the posterior part of the tuberosity restores the supination and flexion moment arms of the biceps. The anterior approach requires protection of the lateral antebrachial cutaneous nerve and the posterior interosseous nerve, which winds around the radial neck. The two-incision approach (Boyd-Anderson) accesses the tuberosity through both anterior and posterior forearm exposures. Partial biceps tendon tears at the tuberosity are increasingly recognised on MRI and may be managed conservatively or with repair.
Sudden forced extension against a contracting elbow flexor avulses the biceps tendon from the radial tuberosity, producing a palpable gap in the antecubital fossa and reverse Popeye deformity with weakness of supination greater than flexion, requiring surgical reattachment to the tuberosity within 2-3 weeks for optimal function.
A rare overuse injury from repetitive pronation-supination in rowers and racquet sport athletes produces anterior elbow pain with tenderness at the radial tuberosity level, diagnosed by MRI showing periosteal oedema and managed with activity restriction until healed.
Inflammation of the bursa between the biceps tendon and the radial tuberosity, causing anterior elbow pain and swelling, sometimes with nerve compression.
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