Abstract
We present the case of a 74 year-old woman with diabetes mellitus and established osteoporosis who initially presented with increasing pain and disability of the shoulders. Investigations showed severe rotator cuff disease. This was treated conservatively with physiotherapy and corticosteroid injection into both joints with good pain relief but no improvement in function. She subsequently presented with increasing posterior thoracic pain with plain films reporting no evidence of rib fracture. Bone scintigraphy showed severe rotator cuff disease and degenerative joint disease at multiple sites. The single photon emission computed tomography (SPECT)/ x-ray Computed Tomography (CT) showed bilateral scapula spine fractures of long standing with a probable non-union on the left side. These fractures are rare and difficult to treat when associated with rotator cuff disease.
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