Complete pectoralis major rupture with ipsilateral full-thickness supraspinatus tear following a wrestling injury

Pectoralis major (PM) rupture during wrestling is well described; however, no previous report of complete PM rupture with an ipsilateral full-thickness supraspinatus tear has been identified following a single event. A 40-year-old man injured his right shoulder while playing wrestling, the arm forced into abduction and external rotation. He believed the joint had dislocated. Radiographs the next day were normal. At specialist review, there was loss of the anterior axillary fold with asymmetry of chest contour; shoulder motion was near-normal, and no cuff-specific sign was present. MRI of the chest wall and the glenohumeral joint demonstrated a full-thickness PM tendon tear with medial retraction and an unsuspected full-thickness supraspinatus tear, with preserved cuff muscle bulk and no fatty degeneration. Both lesions were repaired in a single operation, with an uncomplicated return to gym training and sport. A clinically dominant chest wall injury may conceal a concomitant rotator cuff tear.