OCAD MSK

History

62 yr old male with chronic shoulder pain

Figure 1 for case Os Subscapularis vs Old Lesser Tuberosity Avulsion — Figure 1

Figure 2 for case Os Subscapularis vs Old Lesser Tuberosity Avulsion — Figure 2

Figure 3 for case Os Subscapularis vs Old Lesser Tuberosity Avulsion — Figure 3

Discussion

It appears that this is more likely to represent an Os Subscapularis than a chronic avulsion fracture non-union of the lesser tuberosity. It seems the ossicle is larger than the normal lesser tuberosity, and the subscapularis tendon appears normal. Cyst-like changes deep to the synchondrosis suggest chronic micromotion. Have any of you seen an Os Subscapularis? Does it exist? I could find no reference. BTW the supra and infra are normal, but there is glenohumeral DJD.

Diagnosis

Os Subscapularis vs Old Lesser Tuberosity Avulsion

Hilary Umans, MD

Courtesy

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