Growth plate injury at the base of the coracoid: MRI features

To assess the MRI features of growth plate injury at the base of the coracoid process.

Subjects were identified through retrospective search of our department imaging database and teaching files and the teaching files of two outside academic institutions. The coracoid base growth plate was examined with attention to widening, irregularity, abnormal signal intensity of the growth plate, and the presence of adjacent soft tissue edema. The apposing coracoid and scapular bony surfaces were examined for signal intensity and morphology.

Shoulder MRIs in eight patients with coracoid base growth plate disturbances were retrospectively reviewed (7 males, 1 female, mean age 15 years). Growth plate injury manifested as widening, irregularity and increased signal, apposing bony marrow edema and hypertrophy, and surrounding soft tissue edema. Five subjects were athletes (football, archery, basketball, swimming, rugby), two had a history of neuromuscular disorders, and one subject presented after a fall. Clinical indications included: rule out labral tear (n = 3), rule out rotator cuff tear or fracture after fall (n = 1), nonspecific pain (n = 1), shoulder subluxation, rule out glenoid pathology (n = 1, patient with underlying neuromuscular disorder), muscular dystrophy with shoulder pain (n = 1), and impingement (n = 1). Coracoid growth plate injury was not suspected clinically in any of the patients.

Awareness of the imaging appearance of coracoid base growth plate injury can aid in a more accurate diagnosis of shoulder MRI studies in young pediatric athletes. While uncommon, coracoid growth plate injury should be considered when assessing children with shoulder symptomatology.