Isolated coracoid process apophyseal avulsion fracture

Case contributed by Teun W. F. Pappot
Diagnosis certain

Presentation

A 16 year old male presented with a 2 week history of anterior shoulder pain after swimming and push up exercise.

Patient Data

Age: 16
Gender: Male

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. 

Case Discussion

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. 

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