Intraosseous ganglion cyst of the humeral head in a competitive flat water paddler: case report.

OBJECTIVE To present the diagnostic and clinical features of an intraosseous ganglion cyst of the humeral head of a female flat water canoe athlete. CLINICAL FEATURES An 18-year old female flat water canoeist complaining of right shoulder pain following a strenuous paddling training camp. INTERVENTION AND OUTCOME A trial of passive care was conducted, including soft tissue therapy, spinal manipulative therapy, acupuncture, and rehabilitation. The patient seemed to be responding with treatment, but pain would always resume with paddling. A diagnostic ultrasound displayed mild thickening and effusion in the subacromial/subdeltoid bursae. Continued passive care was not able to resolve the symptoms and she underwent an MRI which revealed an intraosseus ganglion cyst subjacent to the lesser tuberosity and floor of the intertubercular groove. A subsequent MRA was ordered to assess the labrum, which was intact, but the cyst had progressed in size. She was referred to an orthopedic surgeon who performed surgery. CONCLUSION An IOG cyst within the humeral head is a rare, potentially painful condition that can mimic other pathologies including impingement and labral tear. It is important to be aware of the clinical features to obtain a prompt diagnosis and appropriate treatment of this condition.