Spontaneous stress fracture of scapular spine associated with rotator cuff tendinopathy: A rare complication in an elderly patient

Spontaneous stress fracture of the scapular spine associated with rotator cuff tendinopathy is a rare complication in an elderly patient. Rotator cuff tendinopathy is a common condition characterized by degeneration and inflammation of the rotator cuff tendons. On the other hand, stress fractures are small cracks or breaks in bones that occur in response to repetitive or excessive mechanical loading. We present a rare case of a 79-year-old female patient complaining of persistent right shoulder pain that was unresponsive to medication which worsened in the last week and associated with a limited range of motion and inability to raise her arms above her head. Imaging studies revealed a nondisplaced fracture involving the mid-aspect of the scapular spine with surrounding callus formation and adjacent reactive changes. Stress fractures are often observed in weight-bearing bones, but they can also occur in non-weight bearing bones like the scapular spine. The association between rotator cuff tendinopathy and stress fractures of the scapular spine is uncommon and not well-documented in the literature. The biomechanics of the shoulder joint and altered force transmission due to rotator cuff pathology may contribute to the development of stress fractures. This case highlights the need to consider uncommon complications, such as stress fractures, in patients with shoulder pain. A comprehensive approach and early recognition of rare complications can guide appropriate diagnostic and treatment strategies to prevent potential complications and optimize patient outcomes.