title: Case report: bilateral proximal epiphyseal clavicular stress-related lesions in a male gymnast.
abstract: BACKGROUND
  Stress lesions of the upper extremity are relatively uncommon, and physeal stress lesions of the clavicle are rare. We present a case of bilateral physeal stress-related lesions of the proximal clavicular growth plate near the sternoclavicular joint in an adolescent male gymnast.
  
  
  METHODS
  A 13-year-old gymnast presented with a 3-week history of insidious onset of pain in the proximal clavicular area of his left shoulder. He had no pain at rest or at night. He recently had added a new maneuver to his routine. His radiographs were normal, but further study with CT scanning confirmed a stress lesion of his proximal clavicular physis. The lesion healed with time, and he returned to gymnastics with no symptoms. Approximately 5 months after the initial symptoms on the left side, he felt a pop and immediate pain in his right sternoclavicular joint area while doing a routine. Imaging revealed a chronic stress lesion of the proximal physis similar to that of the other side. The patient achieved healing with rest and returned to gymnastics with no limitations.
  
  
  METHODS
  Physeal stress-related lesions of the proximal clavicular physis have not been reported in the literature.
  
  
  CONCLUSIONS
  Medial clavicle pain in adolescent gymnasts may be secondary to stress-related lesions of the proximal clavicular growth plate. Such lesions are rare.
authors: Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
authors: James T
authors: JT
authors: Carson
authors: Teri M
authors: TM
authors: McCambridge
authors: John A
authors: JA
authors: Carrino
authors: Edward G
authors: EG
authors: McFarland
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis / Q000534:rehabilitation; D012090:Cumulative Trauma Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000534:rehabilitation; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000503:physiopathology; D005500:Follow-Up Studies; D006132:Growth Plate / Q000000981:diagnostic imaging / Q000502:physiology; D006173:Gymnastics / Q000293:injuries*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D020127:Recovery of Function; D018570:Risk Assessment; D013247:Sternoclavicular Joint / Q000000981:diagnostic imaging* / Q000293:injuries; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome