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Tug Lesion, Humerus
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Chronic avulsive injury, proliferative periostitis, metaphyseal fibrous defect, cortical irregularity syndrome, periosteal (juxtacortical) desmoid
          • Definitions

            • Reactive fibroosseous mass at bone attachment of major muscle
              • Humerus: Pectoralis major and deltoid insertions
              • Humerus is less common than distal femur cortical desmoid
              • Another shoulder region tug lesion is Bennett lesion on posterior glenoid rim

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Donnelly LF et al: Chronic avulsive injuries of childhood. Skeletal Radiol. 28(3):138-44, 1999
                                    2. Donnelly LF et al: Chronic avulsive injury of the deltoid insertion in adolescents: imaging findings in three cases. Radiology. 211(1):233-6, 1999
                                    3. Martire JR et al: Imaging of athletic injuries: a multimodality approach. New York: McGraw-Hill. 181-279, 1992
                                    4. Chadwick CJ: Tendinitis of the pectoralis major insertion with humeral lesions. A report of two cases. J Bone Joint Surg Br. 71(5):816-8, 1989
                                    5. Fulton MN et al: Cortical desmoid-like lesion of the proximal humerus and its occurrence in gymnasts (ringman's shoulder lesion). Am J Sports Med. 7(1):57-61, 1979
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Synonyms

                                              • Chronic avulsive injury, proliferative periostitis, metaphyseal fibrous defect, cortical irregularity syndrome, periosteal (juxtacortical) desmoid
                                            • Definitions

                                              • Reactive fibroosseous mass at bone attachment of major muscle
                                                • Humerus: Pectoralis major and deltoid insertions
                                                • Humerus is less common than distal femur cortical desmoid
                                                • Another shoulder region tug lesion is Bennett lesion on posterior glenoid rim

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Nuclear Medicine Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Donnelly LF et al: Chronic avulsive injuries of childhood. Skeletal Radiol. 28(3):138-44, 1999
                                                                      2. Donnelly LF et al: Chronic avulsive injury of the deltoid insertion in adolescents: imaging findings in three cases. Radiology. 211(1):233-6, 1999
                                                                      3. Martire JR et al: Imaging of athletic injuries: a multimodality approach. New York: McGraw-Hill. 181-279, 1992
                                                                      4. Chadwick CJ: Tendinitis of the pectoralis major insertion with humeral lesions. A report of two cases. J Bone Joint Surg Br. 71(5):816-8, 1989
                                                                      5. Fulton MN et al: Cortical desmoid-like lesion of the proximal humerus and its occurrence in gymnasts (ringman's shoulder lesion). Am J Sports Med. 7(1):57-61, 1979