Pectoralis major tear

Case contributed by Andrew Murphy

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
MRI
  • there is extensive intramuscular oedema involving the sternal and clavicular heads of the pectoralis major muscle. Intramuscular haematoma 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 oedema/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 fibres 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 fibres are retracted by up to 3 cm.
  • there is no evidence of intra tendinous tear of the pectoralis tendon and no oedema 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.

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Case information

rID: 55847
Published: 27th Sep 2017
Last edited: 27th Sep 2017
Inclusion in quiz mode: Included
Institution: Princess Alexandra Hospital

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