Presentation
Right shoulder pain.
Patient Data
Bone marrow edema signal of the distal clavicle bone marrow with subchondral linear low signal. Normal acromioclavicular joint. Type 1 acromion. No acromial spur or os acromiale.
Long head of biceps is intact. Partial supraspinatus and infraspinatus tears. Mild subacromial bursal thickening.
Chondrolabral separation anteroinferiorly extending from 3 o'clock to 7 o'clock with numerous paralabral cysts.
Case Discussion
There are numerous findings in this case with rotator cuff tears and labral tear with paralabral cysts although most impressive is the distal clavicle bone marrow edema signal with linear subchondral low signal reflecting distal clavicular osteolysis with subchondral insufficiency fracture. This is the most likely cause of acute shoulder pain in this case.