A 27 year old male body-builder presented with bilateral anterior shoulder pain particularly when bench pressing.
Ultrasound showed bilateral hypoechoic pec major insertional thickening (arrows) in keeping with tendonosis. The pattern of imaging abnormality in this case is interesting, being localised to the mid-to-lower tendon slips of the broad pec major tendon construct. Arrowheads indicate normal tendon segments. H= humerus.