Isolated Spontaneous Pectoralis Minor Tendon Rupture in a Patient with Chronic Renal Failure

Abstract

Isolated rupture of the pectoralis minor tendon is extremely rare and has been reported 3 times in 4 patients. This article describes the first case of an isolated spontaneous pectoralis minor tendon tear in an endstage renal disease (ESRD) patient undergoing long-term hemodialysis and with a previous history of bilateral rupture of the quadriceps tendons.He presented with left anterior shoulderand chest wall pain with direct tenderness on palpation over the coracoid. Magnetic resonance imaging revealed an isolated tear of the pectoralis minor tendon with an intact pectoralis major tendon. The patient returned to full activities after conservative management. Although rare, the diagnosis of pectoralis minor tendon rupture should be considered in ESRD patients who present with anterior shoulder pain in the absence of an antecendent trauma.

Keywords

• End-Stage Renal Disease
• Pectoralis Minor
• Tendon Rupture
• Hemodialysis

Kronik Böbrek Yetmezlikli Hastada Spontan İzole Pektoralis Minör Tendon Rüptürü

Abstract

Pektoralis minör tendonunun izole rüptürü son derece nadirdir ve 4 hastada 3 kez bildirilmiștir. Bu makale uzun süredir hemodiyalize giren ve bilateral kuadriseps tendonlarında rüptür hikayesi olan, son dönem böbrek yetmezliği (SDBY) bulunan hastadaki ilk izole spontan pektoralis minör tendon rüptürüdür. Hasta sol ön omuz ve korakoid üzerinde palpasyonla hassasiyet veren göğüs ön duvarı ağrısıyla bașvurdu. Manyetik rezonans görüntülemede sağlam pektoralis major tendonuyla birlikte pektoralis minör tendonu izole rüptürü mevcuttu. Hasta konservatif tedavi sonrası eski aktivite düzeyine döndü. Nadir olmakla birlikte pektoralis minör tendon rüptürü tanısı ön omuz ağrısıyla bașvuran, öncesinde travma öyküsü olmayan SDBY hastalarında düșünülmelidir.

Keywords

• Son Dönem Böbrek Yetmezliği
• Pektoralis Minör
• Tendon Rüptürü
• Hemodiyaliz

References

1. 1. Jones N, Kjellstrand CM. Spontaneous tendon ruptures in patients on chronic dialysis, Am J Kidney Dis. 1996; 28:861-866.
2. 2. Shah MK. Simultaneous bilateral quadriceps tendon rupture in renal patients. ClinNephrol. 2002;58:118-121.
3. 3. Matokovic D, Matijasevic B, Petric P, Crnkovic T, Skorvaga S. A case report of spontaneous concurrent bilateral rupture of the quadriceps tendons in a patient with chronic renal failure. TherApher Dial. 2010;14:104.
4. 4. Celik EC, Ozbaydar M, Ofluoglu D, Demircay E. Simultaneous and spontaneous bilateral quadriceps tendons rupture. Am J Phys Med Rehabil. 2012;91:631- 634.
5. 5. Li X, Gorman MT, Dines JS, Limpisvasti O, Isolated tear of the pectoralis minor tendon in a high school football player. Orthopedics. 2012;35:e1272-1275.
6. 6. Kalra K, Neri B. Isolated pectoralis minor tendon tear in a professional ice hockey player—radiographic findings and presentation. Skeletal Radiol. 2010; 39(12):1251-1253.
7. 7. Mehallo CJ. Isolated tear of the pectoralis minor. Clin J Sport Med. 2004; 14:245- 246.
8. 8. Zvijac JE, Zikria B, Botto-van Bemden A. Isolated tears of pectoralis minor muscle in professional football players: a case series. Am J Orthop (Belle Mead NJ). 2009; 38:145-147.

9. 9. Soo I, Christiansen J, Marion D, Courtney M, Luyckx VA. Sequential rupture of triceps and quadriceps tendons in a dialysis patient using hormone supplements. Clin Nephrol. 2011; 75 Suppl 1:20-23. 10. Muratli HH, Celebi L, Hapa O, Biçimoğlu A. Simultaneous rupture of the quadriceps tendon and contralateral patellar tendon in a patient with chronic renal failure. J Orthop Sci. 2005; 10:227-232. 11. Ureten K, Oztürk MA, Ozbek M, Unverdi S, Spontaneous and simultaneous rupture of both Achilles tendons and pathological fracture of the femur neck in a patient receiving long-term hemodialysis. IntUrolNephrol. 2008;40:1103-1106.
10. 12. Mao-Feng Gao, Hui-Lin Yang, Wei- Dong Shi. Simultaneous bilateral quadriceps tendon rupture in a patient with hyperparathyroidism undergoing long-term hemodialysis: A case report and literature review. J Int Med Res. 2013; 41: 1378.
11. 13. Kurer MH, Baillod RA, Madgwick JC. Musculoskeletal manifestations of amyloidosis A review of 83 patients on hemodialysis for at least ten years. J Bone Joint Surg (Br). 1991; 73:271-276.
12. 14. Kim BS, Kim YW, Song EK, Seon JK, Kang KD, Kim HN. Simultaneous bilateral quadriceps tendon rupture in a patient with chronic renal failure. Knee Surg Relat Res. 2012;24:56-59. 15. Tsourvakas S, Gouvalas K, Gimstas C, et al. Bilateral and simultaneous rupture of the triceps tendons in chronic renal failure and secondary hyperparathyroidism. Arch Orthop Trauma Surg. 2004; 124:278–280. 16. Palmer S, Birks C, Dunbar J, Walker R. Simultaneous multiple tendon ruptures complicating a seizure in a haemodialysis patient. Nephrology. 2004; 9: 262–264.