Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum

We report the case of a 13-year-old male who sustained a right shoulder injury while playing quarterback in an American football game. A noncontrast MRI scan showed evidence of a possible grade 1 SLAP tear (SLAP = superior labral anterior-posterior), and surgery was recommended. However, at the preo...

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Main Authors: John G. Skedros, J. Hunter Marshall, John T. Cronin
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2022/1756611
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author John G. Skedros
J. Hunter Marshall
John T. Cronin
author_facet John G. Skedros
J. Hunter Marshall
John T. Cronin
author_sort John G. Skedros
collection DOAJ
description We report the case of a 13-year-old male who sustained a right shoulder injury while playing quarterback in an American football game. A noncontrast MRI scan showed evidence of a possible grade 1 SLAP tear (SLAP = superior labral anterior-posterior), and surgery was recommended. However, at the preoperative visit, the surgeon was suspicious that the main source of pain had been missed. Bilateral shoulder radiographs taken for comparative analysis revealed a Salter-Harris type I coracoid growth-plate fracture. Therefore, the surgeon planned to manage the patient nonoperatively and postponed the proposed SLAP tear surgery. The patient was instructed to cease participation in athletic events and undergo physical therapy. Hoping to expedite his healing with platelet or stem cell injections, the parents sought an opinion from another physician who obtained a right shoulder MRI with intra-articular contrast. This confirmed that there was no SLAP tear. We concluded that the patient initially had glenohumeral and coracoclavicular ligament strains and a coracoid growth-plate fracture. The SLAP tear suggested by the initial MRI proved to be a red herring, belying an accurate diagnosis. The patient ultimately recovered fully with physical therapy and without surgery or other interventions.
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spelling doaj-art-0b80ca9fac8b4f129e6baf0912575ce92025-02-03T01:00:46ZengWileyCase Reports in Orthopedics2090-67572022-01-01202210.1155/2022/1756611Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic ConundrumJohn G. Skedros0J. Hunter Marshall1John T. Cronin2Utah Orthopaedic SpecialistsUtah Orthopaedic SpecialistsUtah Orthopaedic SpecialistsWe report the case of a 13-year-old male who sustained a right shoulder injury while playing quarterback in an American football game. A noncontrast MRI scan showed evidence of a possible grade 1 SLAP tear (SLAP = superior labral anterior-posterior), and surgery was recommended. However, at the preoperative visit, the surgeon was suspicious that the main source of pain had been missed. Bilateral shoulder radiographs taken for comparative analysis revealed a Salter-Harris type I coracoid growth-plate fracture. Therefore, the surgeon planned to manage the patient nonoperatively and postponed the proposed SLAP tear surgery. The patient was instructed to cease participation in athletic events and undergo physical therapy. Hoping to expedite his healing with platelet or stem cell injections, the parents sought an opinion from another physician who obtained a right shoulder MRI with intra-articular contrast. This confirmed that there was no SLAP tear. We concluded that the patient initially had glenohumeral and coracoclavicular ligament strains and a coracoid growth-plate fracture. The SLAP tear suggested by the initial MRI proved to be a red herring, belying an accurate diagnosis. The patient ultimately recovered fully with physical therapy and without surgery or other interventions.http://dx.doi.org/10.1155/2022/1756611
spellingShingle John G. Skedros
J. Hunter Marshall
John T. Cronin
Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum
Case Reports in Orthopedics
title Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum
title_full Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum
title_fullStr Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum
title_full_unstemmed Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum
title_short Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum
title_sort presumed glenoid slap tear in an adolescent football player belied the presence of a coracoid growth plate fracture a diagnostic conundrum
url http://dx.doi.org/10.1155/2022/1756611
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AT jhuntermarshall presumedglenoidslaptearinanadolescentfootballplayerbeliedthepresenceofacoracoidgrowthplatefractureadiagnosticconundrum
AT johntcronin presumedglenoidslaptearinanadolescentfootballplayerbeliedthepresenceofacoracoidgrowthplatefractureadiagnosticconundrum