Case report: bilateral proximal epiphyseal clavicular stress-related lesions in a male gymnast

Clin Orthop Relat Res. 2012 Jan;470(1):307-11. doi: 10.1007/s11999-011-2154-x. Epub 2011 Nov 2.


Background: Stress lesions of the upper extremity are relatively uncommon, and physeal stress lesions of the clavicle are rare. We present a case of bilateral physeal stress-related lesions of the proximal clavicular growth plate near the sternoclavicular joint in an adolescent male gymnast.

Case description: A 13-year-old gymnast presented with a 3-week history of insidious onset of pain in the proximal clavicular area of his left shoulder. He had no pain at rest or at night. He recently had added a new maneuver to his routine. His radiographs were normal, but further study with CT scanning confirmed a stress lesion of his proximal clavicular physis. The lesion healed with time, and he returned to gymnastics with no symptoms. Approximately 5 months after the initial symptoms on the left side, he felt a pop and immediate pain in his right sternoclavicular joint area while doing a routine. Imaging revealed a chronic stress lesion of the proximal physis similar to that of the other side. The patient achieved healing with rest and returned to gymnastics with no limitations.

Literature review: Physeal stress-related lesions of the proximal clavicular physis have not been reported in the literature.

Purpose and clinical relevance: Medial clavicle pain in adolescent gymnasts may be secondary to stress-related lesions of the proximal clavicular growth plate. Such lesions are rare.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Athletic Injuries / diagnosis
  • Athletic Injuries / rehabilitation
  • Cumulative Trauma Disorders / diagnostic imaging*
  • Cumulative Trauma Disorders / physiopathology
  • Cumulative Trauma Disorders / rehabilitation
  • Epiphyses / diagnostic imaging
  • Epiphyses / physiopathology
  • Follow-Up Studies
  • Growth Plate / diagnostic imaging
  • Growth Plate / physiology
  • Gymnastics / injuries*
  • Humans
  • Injury Severity Score
  • Male
  • Recovery of Function
  • Risk Assessment
  • Sternoclavicular Joint / diagnostic imaging*
  • Sternoclavicular Joint / injuries
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome