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Avulsion fracture - greater tuberosity of humerus

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Pain and limited motion of right shoulder after a fall onto it.

Patient Data

Age: 80 years
Gender: Female

Right shoulder

x-ray

The X-ray showed an avulsion fracture of the greater tuberosity at the site of supraspinatus attachment. The remainder of the bony structures is unremarkable.

Atherosclerotic calcifications are seen at the aortic knob and the left coronary artery is noted.

Right shoulder

mri

Mild glenohumeral joint effusion.  

Avulsed cortical bone of the right greater tuberosity at the attachment of the supraspinatus tendon with underlying altered bone marrow signal being of low T1 and high T2/PD fs signals.

The supraspinatus tendon shows partial thickness tear at its articular surface associated with subacromial/subdeltoid bursitis.

Abnormal intrasubstance increased signal and thickening along the course of subscapularis tendon related to tendinosis associated with subcoracoid bursitis.

The fluid signal around the long head of the biceps tendon in the background of tenosynovitis.

Mild osteoarthritic changes of the acromioclavicular joint.

Low lying type II acromion.

Case Discussion

This case illustrates an avulsion fracture through the greater tuberosity after a fall on the right shoulder.

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