A 41-year-old doorman attended the emergency department with a history of sudden pain and a popping sensation to the anterior aspect of his right shoulder on restraining a person in the course of his work the previous evening. He had swelling and bruising as shown in fig 1. He was diagnosed with a distal rupture of his right pectoralis major muscle (PM). He subsequently underwent surgical exploration and repair.
Figure 1. Presentation of patient showing swelling and bruising. Informed consent was obtained for publication of this figure.
The condition is primarily diagnosed clinically but magnetic resonance imaging is widely accepted as the modality of choice in evaluating possible tears of PM.
Non-surgical management is recommended only for proximal tears and for elderly, sedentary patients. Otherwise, surgery is advocated to enable return to full strength and function. Rehabilitation involves a gradual progression to the increase range of movement and muscle strength, and patients can usually return to full activity in 3–6 months.1
Acknowledgments
This article has been adapted from Catterson P R, Jarman R D. Rupture of pectoralis major: an occupational injury Emergency Medicine Journal 2007;24:799
Footnotes
Competing interests: none
REFERENCE
- 1.Petilon J, Carr D, Sekiya J, et al. Pectoralis major muscle injuries: evaluation and management. J Am Acad Orthop Surg 2005; 13: 59–68 [DOI] [PubMed] [Google Scholar]
