The brachialis has a central tendinous septum that runs through the anterior muscle belly, providing internal architecture for force transmission. This septum is the basis for the characteristic bipennate internal structure of the brachialis.
The brachialis mid-belly tendinous septum is the structure involved in myositis ossificans after anterior elbow trauma, where heterotopic ossification forms along this internal tendon. CT demonstrates calcification within the brachialis belly following elbow dislocation. The ossification follows the tendinous septum pattern, producing an arc-shaped calcification on lateral elbow X-ray.
Heterotopic ossification along the brachialis central tendinous septum after elbow dislocation producing progressive flexion loss and an anterior elbow mass, requiring surgical excision after radiographic maturation.
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