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First published on October 11, 2005, doi:10.1177/0363546505279573
This version was published on February 1, 2006
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The American Journal of Sports Medicine 34:289-294 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

Pectoralis Major Tears

Correlation of Magnetic Resonance Imaging and Treatment Strategies

John E. Zvijac, MD*, Matthias R. Schurhoff, MD, Keith S. Hechtman, MD and John W. Uribe, MD

From Uribe Hechtman Zvijac Sports Medicine Institute, Coral Gables, Florida

* Address correspondence to John E. Zvijac, MD, UHZ Sports Medicine Institute, 1150 Campo Sano Avenue, Suite 200, Coral Gables, FL 33146 (e-mail: jzvijac{at}uhzsmi.com).

Background: Controversy exists in the diagnosis and treatment of pectoralis major tear patterns.

Hypothesis: Magnetic resonance imaging is useful in determining the grade and the location of pectoralis major tears and in guiding toward an appropriate treatment plan.

Study Design: Case series; Level of evidence, 4.

Methods: Between January 1998 and December 2002, 27 patients were treated for pectoralis major tears. All patients were evaluated by history and physical examination. A clinical impression was formed regarding the location and grade of injury, and a treatment plan was established. All patients underwent magnetic resonance imaging, and images were reviewed by an orthopaedic surgeon and a board-certified musculoskeletal radiologist, resulting in a final treatment plan. The mean follow-up was 12 months. All patients were evaluated by questionnaire and clinical examination to assess pain, function, deformity, and overall satisfaction.

Results: In 19 of 27 patients, the clinical impression and magnetic resonance imaging agreed regarding the location and the grade of the injury. A total of 19 patients underwent surgical repair, and 8 patients were treated nonoperatively. The magnetic resonance imaging result changed the treatment plan in 3 patients from operative to nonoperative.

Conclusion: The clinical impression appeared to overestimate the severity, the location, and the grade of the injury. Magnetic resonance imaging provided a more accurate assessment and, in conjunction with the clinical examination, helped to identify those patients who would benefit most from surgical repair.

Key Words: pectoralis major tear • magnetic resonance imaging (MRI) evaluation • treatment






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