Isolated coracoid process apophyseal avulsion fracture
A 16 year old male presented with a 2 week history of anterior shoulder pain after swimming and push up exercise.
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MRI imaging demonstrates a cortical apophyseal avulsion fracture of the short head of the biceps tendon and accompanying avulsion of the brachialis tendon at their coracoid process attachment. The pectoralis minor insertion is preserved.
A proximal long head of the biceps tendon rupture is relatively common. His close proximity to the anterior and superior rotator cuff predisposes the long head of the biceps tendon to injuries, especially in the setting of chronic rotator cuff pathology.
However, an isolated proximal short head of the biceps tendon injury is rare, with only a few case reports published in recent literature. Treatment is usually conservative.
- Rupture of the short head tendon of the biceps brachii. Postacchini F, Ricciardi-Pollini PT.Clin Orthop Relat Res. 1977 May;(124):229-32
- Coracoid Process: The Lighthouse of the Shoulder, Hussan Mohammed, MDMatthew R. Skalski, DCDakshesh B. Patel, MDAnderanik Tomasian, MDAaron J. Schein, MDEric A. White, MDGeorge F. Rick Hatch III, MDGeorge R. Matcuk Jr, MD Radiographics. 2016 Nov-Dec;36(7):2084-2101. Epub 2016 Jul 29