Acute Parsonage-Turner syndrome
Sudden onset severe shoulder pain and weakness
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Sagittal, coronal, and axial Fat Sat MR shows edema of the supraspinatus, infraspinatu , and teres minor muscles. The deltoid muscle is spared. This case also shows supraspinatus tendinopathy (downsloping acromion) and mild subacromion/subdeltoid bursitis.
Rotator Cuff Denervation Syndromes is caused by variety of causes, most important are:
- Viral neuritis: Parsonage-Turner syndrome
- Fibrous bands
- Paralabral cyst
- Nerve injury (stretching/traction injury)
In this case, the distribution of muscles affected doesn't follow the anatomical muscle innervation, which favors Parsonage-Turner syndrome.
Typical anatomical nerve distributions are:
- suprascapular nerve
- supraspinatus muscle
- infraspinatus muscle
- axillary nerve
- teres minor muscle (5th cervical nerve)
- deltoid muscle (5th & 6th cervical nerves)
- subscapular nerve
- subscapularis muscle
Please note that the chronic stage differs in MRI appearance.