The patient had a nonunion of a previous left coracoid fracture. The initial management at the time of his injury focused on the proximal humerus fracture; however, his persistent pain was attributed to this coracoid nonunion. Subtle widening of the left coracoid physis was evident on CT and it was not readily visible on plain radiographs. MRI of the left shoulder suggested signal increase at the base of the coracoid consistent with edema. A bone scan suggested decreased uptake at the left coracoid, which supports altered physeal activity. After discussion with the patient and his family, the decision was made for operative management of the coracoid nonunion.