Acute Parsonage-Turner syndrome

Case contributed by Dr Amro Omar

Presentation

Sudden onset severe shoulder pain and weakness

Patient Data

Age: 30
Gender: Male
Modality: MRI

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.

Case Discussion

Rotator Cuff Denervation Syndromes is caused by variety of causes, most important are:

  1. Viral neuritis: Parsonage-Turner syndrome
  2. Fibrous bands
  3. Paralabral cyst
  4. 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.

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Case Information

rID: 34076
Case created: 3rd Feb 2015
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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