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Crest of lesser tubercle

he crest of the lesser tubercle is a bony ridge located on the anterior aspect of the proximal humerus, extending inferiorly from the lesser tubercle. It forms the medial lip of the intertubercular (bicipital) groove and serves as an important attachment site for muscles contributing to shoulder stability and movement.

It is a key anatomical landmark in shoulder anatomy, orthopedic surgery, and imaging evaluation of the proximal humerus.

Synonyms

  • Medial lip of the bicipital groove

  • Crest of the minor tubercle

Location

  • Situated on the anterior proximal humerus

  • Extends inferiorly from the lesser tubercle

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

  • Medial to the greater tubercle

  • Lateral to the humeral head and surgical neck

Anatomical components

  • Bony ridge of compact cortical bone

  • Continuous superiorly with the lesser tubercle

  • Forms part of the proximal humeral metaphysis

  • Muscle attachment zone:

    • Teres major muscle

  • Contributes to the wall of the bicipital groove, guiding the long head of the biceps tendon

Relations

Anteriorly:

  • Deltoid muscle fibers

Posteriorly:

  • Proximal humeral shaft

Medially:

  • Humeral head and surgical neck

Laterally:

  • Intertubercular (bicipital) groove

  • Tendon of the long head of biceps brachii

Superiorly:

  • Lesser tubercle

Inferiorly:

  • Insertion region of teres major muscle

X-ray appearance

Plain radiographs (AP shoulder and humerus views):

  • Crest: Subtle linear bony ridge adjacent to the medial margin of the bicipital groove

  • Best visualized on: Internal rotation and true AP views

  • Relationship: Seen bordering the medial aspect of the intertubercular groove

CT appearance

Non-contrast CT:

  • Crest: Well-defined bony ridge extending from the lesser tubercle

  • Cortical margins: Sharp and continuous

  • Trabecular pattern: Normal cancellous bone

  • Spatial detail: Excellent depiction of the bicipital groove and its medial wall

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow of proximal humerus: High signal

  • Crest contour: Clearly defined against surrounding soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Adjacent soft tissues: Intermediate-to-high signal

  • Biceps tendon in groove: Low signal linear structure

STIR:

  • Fat suppression: Uniform suppression of marrow fat

  • Crest margins: Well delineated

  • Surrounding tendons and soft tissues: Bright signal allowing contrast

Proton density fat-saturated (PD FS):

  • Bone marrow: Suppressed fat signal

  • Long head of biceps tendon: Clearly visualized as low-signal structure in the groove

  • Teres major insertion area: Well demonstrated

CT VRT 3D image

crest of lesser tubercle 3d

MRI image

crest of lesser tubercle mri anatomy labelled image-img-00000-00000