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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:25-31 • 0278-4297

Sonographic Findings of Pectoralis Major Tears With Surgical, Clinical, and Magnetic Resonance Imaging Correlation in 6 Patients

Jennifer S. Weaver, MD, Jon A. Jacobson, MD, David A. Jamadar, MBBS, Sean E. Theisen, MD, Farhad Ebrahim, MD and Monica Kalume-Brigido, MD

Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan USA (J.S.W., J.A.J., D.A.J., F.E., M.K.-B.); and Toledo Radiological Associates, Toledo, Ohio USA (S.E.T.).

Address correspondence and reprint requests to Jon A. Jacobson, MD, Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, TC-2910G, Ann Arbor, MI 48109-0326 USA. E-mail: jjacobsn{at}umich.edu

Objective. The purpose of this research was to describe the sonographic findings of pectoralis major injuries with clinical, surgical, and magnetic resonance imaging (MRI) correlation. Methods. Images from sonographic examinations of the pectoralis major muscle of 6 patients were retrospectively evaluated and characterized. The sonographic findings were compared with clinical, surgical, and MRI findings. Results. The 6 patients were male (mean age, 30 years) with injuries sustained during weight lifting, football, and shotgun firing. Two of the 6 patients had MRI correlation; 1 had surgical correlation; 2 had both surgical and MRI correlation; and 1 had clinical follow-up. The sternal head was injured in 5 patients; 4 involved the musculotendinous junction, and 1 involved the distal tendon. The sonographic findings of muscle fiber retraction and surrounding hemorrhage allowed identification of the affected muscle. Direct impact injury causing hematoma involved the clavicular head in 1 patient. In total, 5 cases were partial-thickness pectoralis major tears, whereas complete distal tendon disruption was found in 1. Conclusions. Sonographic imaging longitudinal to the pectoralis muscle fibers showed fiber disruption, retraction, and possible hypoechoic or anechoic hematoma, most commonly involving the musculotendinous junction of the sternal head. Distal tendon assessment is important to evaluate for a full-thickness pectoralis major tear.

Key Words: magnetic resonance imaging • muscles, injuries • muscles, magnetic resonance imaging • muscles, sonography • sonography

Abbreviations: MRI, magnetic resonance imaging • PD, proton density • TE, echo time • TR, repetition time

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Copyright © 2005 by the American Institute of Ultrasound in Medicine.