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Crest of greater tubercle

The crest of the greater tubercle refers to the prominent bony ridge extending inferiorly from the greater tubercle of the humerus along the lateral margin of the intertubercular (bicipital) groove. It forms part of the proximal humeral anatomy and serves as an important landmark for tendon and muscle attachments and for orientation during shoulder imaging and surgery.

It plays a key role in the structural organization of the proximal humerus and the mechanics of the shoulder girdle.

Synonyms

  • Lateral lip of the bicipital groove

  • Lateral crest of the intertubercular sulcus

Location

  • Situated on the proximal humerus

  • Extends inferiorly from the greater tubercle

  • Forms the lateral boundary of the intertubercular (bicipital) groove

  • Lateral to the humeral head

  • Anterior to the surgical neck region

Anatomical components

  • Osseous ridge continuous with the greater tubercle

  • Cortical bone with underlying cancellous bone

  • Muscle and tendon attachment zone:

    • Insertion of the pectoralis major tendon (lateral lip)

  • Defines lateral margin of the bicipital groove, which houses the long head of the biceps tendon

Relations

Anteriorly:

  • Intertubercular (bicipital) groove

  • Long head of the biceps tendon

Posteriorly:

  • Greater tubercle proper

  • Insertion areas for supraspinatus, infraspinatus, and teres minor tendons

Medially:

  • Intertubercular groove

  • Lesser tubercle (via groove floor and medial crest)

Laterally:

  • Deltoid muscle mass

Superiorly:

  • Greater tubercle apex

Inferiorly:

  • Proximal humeral shaft

X-ray appearance

Plain radiographs (AP and lateral shoulder views):

  • Crest: Seen as a subtle linear bony ridge lateral to the bicipital groove

  • Best visualized on: True AP and internal rotation views

  • Relationship: Defines lateral margin of the groove

CT appearance

Non-contrast CT:

  • Crest: Sharp osseous ridge with well-defined cortical margins

  • Continuity: Seen extending from the greater tubercle inferiorly

  • Spatial detail: Clearly separates the bicipital groove from the lateral humeral surface

  • Useful for: Precise evaluation of morphology and alignment

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow: High signal within adjacent humeral head and shaft

  • Crest contour: Clearly outlined against surrounding soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Adjacent soft tissues and bicipital groove: Higher signal

  • Tendons: Low-signal bands inserting near the crest

STIR:

  • Fat suppression: Uniform suppression of marrow fat

  • Crest margins: Well delineated

  • Surrounding soft tissues: High signal

Proton density fat-saturated (PD FS):

  • Bone marrow: Suppressed fat signal

  • Biceps tendon in groove: Well visualized as low-signal structure

  • Pectoralis major tendon insertion: Clearly defined along the crest

CT VRT 3D image

Crest of greater tubercle

MRI image

Crest of Greater Tubercle x ray anatomy labelled image-img-00000-00000