Billham Jessica F, Welk Aaron, Estrada Patricia, Kettner Norman W
Norman W. Kettner, DC Imaging Center, Logan University, Chesterfield, Missouri.
Montgomery Health Center, Logan University, Chesterfield, Missouri.
J Chiropr Med. 2024 Mar-Jun;23(1-2):59-63. doi: 10.1016/j.jcm.2024.02.007. Epub 2024 Sep 17.
The purpose of this report is to describe the presentation of a patient with a pectoralis major tendon (PMJ) tear.
A 30-year-old male weightlifter presented to a chiropractor with localized left arm pain that began while bench-pressing. Ecchymosis and swelling were present, but no contour abnormalities were seen. All active shoulder ranges of motion were painful with the exception of adduction, which was palliative but weak. A 4-week trial-of-care alleviated pain, but weakness persisted.
Diagnostic ultrasound (US) and magnetic resonance imaging (MRI) were ordered. Disruption and retraction of the PMJ were identified on US, and MRI confirmed a PMJ tear. The tear was surgically repaired, and the patient achieved optimal recovery.
This case report provides a clinical example that complete PMJ tears may be difficult to clinically differentiate from a partial tear and must be clarified with imaging.
本报告旨在描述一例胸大肌肌腱(PMJ)撕裂患者的临床表现。
一名30岁的男性举重运动员因在卧推时开始出现的左臂局部疼痛前来就诊于一名脊椎按摩师。有瘀斑和肿胀,但未见轮廓异常。除内收外,所有主动肩部活动范围均疼痛,内收虽可缓解疼痛但力量减弱。为期4周的护理试验缓解了疼痛,但无力症状持续存在。
安排了诊断性超声(US)和磁共振成像(MRI)检查。超声检查发现胸大肌肌腱中断和回缩,MRI证实为胸大肌肌腱撕裂。撕裂处进行了手术修复,患者实现了最佳恢复。
本病例报告提供了一个临床实例,即完全性胸大肌肌腱撕裂在临床上可能难以与部分撕裂相鉴别,必须通过影像学检查加以明确。