Case Report: Bilateral Proximal Epiphyseal Clavicular Stress-related Lesions in a Male Gymnast

Abstract

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.

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

“…These injuries have also been reported in other overhead sports including badminton [54], cricket [56], football [48], gymnastics [57][58][59], tennis [31,46], swimming, and volleyball [60,61]. There is also a reported case of bilateral physeal stress lesions of the proximal clavicular physis in a skeletally immature male gymnast [62].…”

Sternoclavicular reconstruction with “sternal docking” technique and suture tape augmentation in an elite gymnast: a case report

“…Among these, partial rotator cuff tears, labral tears, or glenohumeral multidirectional instability is common. 7 While cases of stress fractures of the clavicle have been reported in gymnasts, 3 , 6 no other cases of SC reconstructions in these athletes have been reported in the literature to date.…”