Presentation
History of fall on the ground about three weeks before the presentation. Complaining of right shoulder pain.
Patient Data
There is a fracture of the lesser tuberosity of the humerus head. There is no dislocation/ bone lesion. The fracture can be seen in all three views.
There is an avulsion fracture of the lesser tuberosity of the humeral head with about 4 mm displacement. The subscapularis tendon shows a normal echo pattern. The biceps long head tendon is normal in position with a normal echo pattern and without tenosynovitis. The supraspinatus tendon is intact with few areas of loss of normal echo pattern favoring tendinosis. The infraspinatus tendon is normal. The supraspinatus and infraspinatus muscle bellies show normal bulk without fatty infiltration. There is a mild capsular thickening of the acromioclavicular joint.
Case Discussion
The radiographs show an avulsion fracture of the humerus head lesser tuberosity. The ultrasound provides additional information about the rotator cuff and displacement of the avulsed bone fragment.
Avulsion injuries are more common in the younger age group. The greater tuberosity avulsion injury is much more common than the lesser tuberosity.