Scapular stress fracture initially masquerading as tumor or infection

We present a case of a scapular stress fracture in a 17-year-old athletic male that was initially thought to be a neoplasm. Radiographs showed a lesion at the neck of the glenoid with aggressive features. A subsequent MRI and bone scan supported a diagnosis of either tumor or infection. However, before a scheduled bone biopsy, a screening chest CT for pulmonary metastases revealed features of a healing stress fracture. The patient ceased intense athletic activity and four weeks later experienced a continued decrease in shoulder symptoms. A followup shoulder CT confirmed a healing fracture. This case illustrates how a stress fracture at an uncommon location may mimic a neoplasm. CT provides complementary information to radiography and MRI and helps establish a definitive diagnosis.