Purpose or Case Report:


This is a case report of a 15-year-old boy with chronic intermittent left shoulder pain due to an undiagnosed lesser tuberosity avulsion fracture, an associated biceps pulley injury and intra-articular dislocation of the long head of the biceps tendon. Also presented is a companion case of a 13-year-old boy with an acute lesser tuberosity avulsion with an intact biceps pulley. Avulsion fractures of the lesser tuberosity are rare injuries which can be difficult to diagnose clinically and on radiographs. Even more rare are reported cases of biceps pulley injuries in children and adolescents with lesser tuberosity avulsions. Utilizing the imaging from these two cases we review lesser tuberosity avulsions in children and also review the complex anatomy of the biceps pulley, which due to its close association with the lesser tuberosity, may be involved in these injuries. These cases emphasize the importance of MR in the diagnosis and treatment planning of lesser tuberosity avulsions.
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