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Incomplete joint side tear of the subscapularis tendon with a small fragment in an adolescent tennis player: a case report.

Kato S, Funasaki H, Kan I, Yoshida M, Kasama K, Marumo K - Sports Med Arthrosc Rehabil Ther Technol (2012)

Bottom Line: He was subsequently diagnosed with incomplete joint side tear of the subscapularis tendon with a small bony fragment.Subsequently, we performed arthroscopic excision of the bony fragment and repair of the subscapularis tendon.This case highlighted the presence of an injury with minor trauma associated with repeated tennis strokes in a skeletally immature patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. soki@jikei.ac.jp.

ABSTRACT

Case: In this case report, we presented the case of an adolescent tennis player with avulsion injury of the subscapularis tendon of the right shoulder.

Patients: A 17-year-old right-hand-dominant male tennis player visited our hospital complaining of pain in the anterior aspect of the right shoulder. We performed X-ray and three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) scans for the diagnosis.

Results: Plain radiographs did not reveal the presence of lesion; however, 3D-CT and MRI scans showed a small bony fragment located between the humeral head and the glenoid of the scapula and a high-intensity area of the subscapularis tendon. He was subsequently diagnosed with incomplete joint side tear of the subscapularis tendon with a small bony fragment. Subsequently, we performed arthroscopic excision of the bony fragment and repair of the subscapularis tendon.

Conclusions: This case highlighted the presence of an injury with minor trauma associated with repeated tennis strokes in a skeletally immature patient.

No MeSH data available.


Related in: MedlinePlus

A three-dimensional-computed tomography (3D-CT) image shows a small bony fragment located between the humeral head and the glenoid of the scapula (arrow).
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Figure 3: A three-dimensional-computed tomography (3D-CT) image shows a small bony fragment located between the humeral head and the glenoid of the scapula (arrow).

Mentions: Plain radiographs (true anteroposterior and scapular views) of the right shoulder did not show any fracture or deformity (Figure1). He was subsequently examined using magnetic resonance imaging (MRI). The T1-weighted images showed a low-intensity area at the lesser tuberosity, and the T2-weighted images showed a high-intensity area at the subscapularis tendon (Figure2). Computed tomography (CT) was performed with the arm being elevated and in an internal rotation. Unfortunately, we could not confirm a small bony fragment and lesser tuberosity in the same slice because of the distinct position. However, conventional CT revealed an irregularity and osteosclerotic change at the medial edge of the lesser tuberosity. Three-dimensional CT (3D CT) revealed a small bony fragment located between the humeral head and the scapular glenoid in the position for pain provocation (Figure3). On the basis of these results, his condition was diagnosed as an avulsion fracture of the lesser tuberosity. However, even though it was an avulsion fracture, we intended to remove the bony fragment, because it was very small and repair the tendon.


Incomplete joint side tear of the subscapularis tendon with a small fragment in an adolescent tennis player: a case report.

Kato S, Funasaki H, Kan I, Yoshida M, Kasama K, Marumo K - Sports Med Arthrosc Rehabil Ther Technol (2012)

A three-dimensional-computed tomography (3D-CT) image shows a small bony fragment located between the humeral head and the glenoid of the scapula (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475128&req=5

Figure 3: A three-dimensional-computed tomography (3D-CT) image shows a small bony fragment located between the humeral head and the glenoid of the scapula (arrow).
Mentions: Plain radiographs (true anteroposterior and scapular views) of the right shoulder did not show any fracture or deformity (Figure1). He was subsequently examined using magnetic resonance imaging (MRI). The T1-weighted images showed a low-intensity area at the lesser tuberosity, and the T2-weighted images showed a high-intensity area at the subscapularis tendon (Figure2). Computed tomography (CT) was performed with the arm being elevated and in an internal rotation. Unfortunately, we could not confirm a small bony fragment and lesser tuberosity in the same slice because of the distinct position. However, conventional CT revealed an irregularity and osteosclerotic change at the medial edge of the lesser tuberosity. Three-dimensional CT (3D CT) revealed a small bony fragment located between the humeral head and the scapular glenoid in the position for pain provocation (Figure3). On the basis of these results, his condition was diagnosed as an avulsion fracture of the lesser tuberosity. However, even though it was an avulsion fracture, we intended to remove the bony fragment, because it was very small and repair the tendon.

Bottom Line: He was subsequently diagnosed with incomplete joint side tear of the subscapularis tendon with a small bony fragment.Subsequently, we performed arthroscopic excision of the bony fragment and repair of the subscapularis tendon.This case highlighted the presence of an injury with minor trauma associated with repeated tennis strokes in a skeletally immature patient.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. soki@jikei.ac.jp.

ABSTRACT

Case: In this case report, we presented the case of an adolescent tennis player with avulsion injury of the subscapularis tendon of the right shoulder.

Patients: A 17-year-old right-hand-dominant male tennis player visited our hospital complaining of pain in the anterior aspect of the right shoulder. We performed X-ray and three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) scans for the diagnosis.

Results: Plain radiographs did not reveal the presence of lesion; however, 3D-CT and MRI scans showed a small bony fragment located between the humeral head and the glenoid of the scapula and a high-intensity area of the subscapularis tendon. He was subsequently diagnosed with incomplete joint side tear of the subscapularis tendon with a small bony fragment. Subsequently, we performed arthroscopic excision of the bony fragment and repair of the subscapularis tendon.

Conclusions: This case highlighted the presence of an injury with minor trauma associated with repeated tennis strokes in a skeletally immature patient.

No MeSH data available.


Related in: MedlinePlus