Clay-shoveler's fracture. Stress fracture of the lower cervical and upper thoracic spinous processes.

Clay-shoveler's fracture is a fatigue fracture of a lower cervical or upper thoracic spinous process. This occupational injury occurs primarily in workers who shovel heavy loads for long periods of time. It was common and well known at the beginning of the XXth century, but has become relatively rare since the introduction of earth-moving machinery, and is now frequently overlooked. A review of clay-shoveler's fracture is presented. Emphasis is put on the legal aspects that can raise problems for rheumatologists, radiologists, occupational physicians and physicians performing expert evaluations of patients filing compensation claims.