Pectoralis major tear: look beyond the shoulder

Question 1Where does the pectoralis major tendon insert?

1. aThe greater tuberosity
2. bThe coracoid process
3. cThe clavicle
4. dThe lateral lip of the bicipital groove of the humerus

Question 2Which history suggests a pectoralis major tear?

1. aA fall onto an outstretched hand in an older adult
2. bPain only at night
3. cGradual shoulder pain over months
4. dA pop at the front of the shoulder during a heavy bench press

Question 3What does a complete tear look like on ultrasound?

1. aNo tendon at the humerus, a gap and a retracted stump
2. bA continuous bright tendon
3. cA thickened tendon with normal fibres
4. dA bright line with a shadow

Question 4Which movement is weak in a pectoralis major tear?

1. aShoulder abduction only
2. bElbow flexion
3. cResisted adduction and internal rotation
4. dWrist extension

Question 5Why is early referral important?

1. aIt only matters for the shoulder joint
2. bRepair in the first few weeks gives the best results
3. cImaging is never needed
4. dThe tear always heals without treatment