Age / Sex : 17 / M

Thrower’s shoulder: Bennet lesion + Little leaguer’s shoulder

Discussion

Findings:

- Posterior glenoid labroligamentous compex hypertrophy with chronic incomplete labral chondral disruption, & R/O contiguous bony hypertrophy in glenoid rim (Bennett lesion).

- Subtle marrow edema along lateral apophyseal line in humeral greater tuberosity.

Differential Diagnosis: 

Diagnosis: 

-       Thrower’s shoulder: Bennet lesion + Little leaguer’s shoulder

Discussion: Thrower’s shoulder

-       Overhead throwing by a baseball pitcher is perhaps the fastest human athletic movement.

-       Adaptive changes to the stress of pitching

• Soft tissue change: Fibrosis, shortening, thickening of posterior capsule


• Osseous change: Humeral retrotorsion, glenoid retroversion

-       Injuries related to the late cocking phase of pitching

• Internal impingement: posterosuperior m/c, articular partial tear of posterior SST/ anterior IST


• SLAP, posterior m/c

-       Injuries related to the deceleration & follow-through phases of pitching

• Glenohumeral Internal Rotation Deficit (GIRD): d/t pathologic contracture of posterior capsule


• Bennett lesion: bony protuberance of posteroinferior glenoid cortex adjacent to the posterior band of IGHL complex.

-       Little leaguer’s shoulder

• Stress-related injury to the proximal humeral physis in adolescent athletes
   

References:

1.     I-Yuan Joseph Chang et al. Pathomechanics and Magnetic Resonance Imaging of the Thrower’s Shoulder. Radiol Clin N Am 54 (2016) 801–815

2.     Hugue Ouellette et al. Spectrum of shoulder injuries in the baseball pitcher. Skeletal Radiol (2008) 37:491–498