Presentation
Shearing pain in left pectoralis during a bench press, significant swelling, defect in pectoral size compared to the right.
Patient Data
Age: 20 years
Gender: Male
From the case:
Pectoralis major tear
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/62432/annotated_viewer_json?lang=us"}
- there is extensive intramuscular edema involving the sternal and clavicular heads of the pectoralis major muscle. Intramuscular hematoma is seen in the mid-portion of the muscle.
- myofascial fluid and intermuscular fluid is seen anterior to the pectoralis minor muscle and biceps muscle belly.
- there is minor subcutaneous edema/bruising seen over the anterior chest wall and anteromedial aspect of the proximal upper limb.
- there is a tear of the muscle-tendon junction.This tear involves the central portion of the tendinous insertion with intact fibers of the lateral most aspect of the clavicular head and inferior most aspect of the sternal/abdominal head. Within the central aspect of the lateral pectoralis muscle, the fibers are retracted by up to 3 cm.
- there is no evidence of intra tendinous tear of the pectoralis tendon and no edema is seen extending to the humerus to indicate a tendon-bone junction injury. The long head biceps tendon is normally positioned.
- neurovascular structures appear intact.
Case Discussion
A tear of the pectoralis major is a considerably uncommon injury, often occurring during forceful activity such as bench press. Early diagnosis via MRI and surgical repair is important to ensure a sound recovery.