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Acute Parsonage-Turner syndrome

Case contributed by Amro Omar
Diagnosis probable

Presentation

Sudden onset severe shoulder pain and weakness.

Patient Data

Age: 30 years
Gender: Male

Sagittal, coronal, and axial fat-saturated MR images show edema of the supraspinatus, infraspinatus, and teres minor muscles. The deltoid muscle is spared.

This case also shows findings of supraspinatus tendinopathy, a downsloping acromion, and mild subacromion/subdeltoid bursitis.

Case Discussion

Rotator cuff denervation syndromes may be due to by a variety of causes, most important are:

  • viral or autoimmune neuritis: Parsonage-Turner syndrome
  • fibrous bands
  • paralabral cyst
  • traumatic nerve injury (stretching/traction injury)

Typical muscular innervations are:

In this case, the distribution of affected muscles doesn't follow a single myotomic innervation, consistent with a polyneuropathy such as Parsonage-Turner syndrome.

Please note that the chronic stage differs in MRI appearance.

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