Subscapularis Myotendinous Junction Tears Presenting with Posterior Shoulder Pain in Overhead Throwing Athletes

Abstract

Objective. Acute inferior subscapularis myotendinous junction injuries are occasionally seen in overhead throwing athletes, and can present with posterior shoulder pain.

Case Reports. Four professional baseball pitchers presented with acute onset of posterior shoulder pain while pitching. After thorough, routine physical examination of the shoulder by the referring orthopaedic surgeon magnetic resonance imaging (MRI) was performed within 7-10 days of the onset of presenting symptoms and interpreted in consensus by 2 fellowshiptrained musculoskeletal radiologists with 9 and 5 years of experience and a musculoskeletal radiology fellow. The patients were then treated conservatively for subscapularis musculotendinous injuries and clinically assessed for symptom resolution before they were allowed to return to play.

Conclusion. Inferior subscapularis myotendinous junction injuries should be included in the differential diagnosis of baseball pitchers with posterior shoulder pain.