Symptomatic SLAP Tear and Paralabral Cyst in a Pediatric Athlete

Abstract

Shoulder injuries in pediatric and adolescent athletes are being increasingly encountered by orthopaedic surgeons as early participation in throwing sports continues to grow at a rapid rate1-8. While shoulder pain is a common complaint of both adult and pediatric athletes, the etiology of their symptoms is often very different. Rotator cuff tears and labral pathology are common causes of shoulder pain in skeletally mature throwing athletes, yet these structures have rarely been reported as a cause of shoulder pain in the skeletally immature thrower9-13. Chronic overuse resulting in proximal humeral epiphysiolysis (Little League shoulder syndrome), osteolysis of the distal end of the clavicle, or injury to the capsulolabral complex have more frequently been implicated1-8. We present the case of an eleven-year-old baseball player with a symptomatic superior labral tear and paralabral cyst. The parents of the patient were informed that data concerning the case would be submitted for publication, and they consented. An eleven-year-old, right-hand-dominant, avid baseball player presented to our clinic with pain in the right shoulder. While he had no history of a single traumatic event or dislocation, the symptoms had developed over the previous three months with overhead throwing. He complained of diffuse soreness and weakness of the right shoulder precipitated by throwing and occasionally during batting practice. He was evaluated by his pediatrician, who diagnosed a Little League shoulder syndrome secondary to overuse and recommended a four-week period of rest with cessation of overhead sports. While the rest reduced the pain somewhat, the symptoms immediately recurred with his return to baseball and then precluded his completion of the season. He presented to our office as a normal-appearing adolescent in no apparent distress. Clinical examination revealed no gross atrophy of the deltoid, trapezius, or rotator …