Slipped Humeral Epiphysis

Ray Ballinger, MD, PhD

Straub Clinic and Hospital

rballinger at


14 y/o with 2 weeks of right shoulder pain


msk shoulder all plain

Publication Date: 10 October 2003

History and Images

14 y/o with 2 weeks of right shoulder pain. He is a pitcher in little league and has been practicing and playing daily.

Right shoulder, ext. rotationRight shoulder, internal rotationComparison view of left shoulder


Subluxation of the proximal humeral epiphysis of the right shoulder is noted. The normal left side is provided for comparison.


Slipped Humeral Epiphysis (Little league shoulder syndrome)


The slipped humeral epiphysis is a chronic stress injury in the dominant arm of adolescents who participate in ovehead sports such as baseball. It is most commonly seen in 12-15 y/o boys, frequently pitchers. Limitations on the number of pitches that a little league pitcher can throw have been recommended by the official Little League organization.