Parsonage turner syndrome
50-year-old male patient presented with a history of gradually increasing left shoulder pain for the last 1 year radiating to left upper extremity and restricting the range of movement. No history of trauma.
Loading Stack -
0 images remaining
MRI left shoulder without contrast shows hyperintense signal in multiple muscles predominantly involving supraspinatus, infraspinatus and part of the deltoid muscles on T2 fat sat images. No mass lesion compressing the axillary or suprascapular nerve.No atrophy or fatty infiltration.
Parsonage-Turner syndrome is an acute idiopathic brachial neuritis. It is twice as common in men than women 1.
Almost all cases involve the suprascapular nerve with nearly 50% of the cases solely affecting it. One-third of the case are bilateral 2.
The aetiology of Parsonage-Turner syndrome is unclear; however, few predisposing factors are suggested such as minor trauma, surgery, gunshot wounds and infections 3,4.
On MRI shoulder, muscles initially look normal, but over the next few weeks, muscular denervation changes appear as high T2 signal, as in the current case. Later on, atrophy and fatty infiltration well develop with reduced muscle bulk and increased T1 signal.
The condition usually responds to conservative treatment 2.
Case submitted by Dr Abeer Ahmed Alhelali and Dr Mohamed Ashfaque Kukkady.
- Scalf RE, Wenger DE, Frick MA et-al (2007) MRI findings of 26 patients with Parsonage-Turner syndrome.. AJR Am J Roentgenol.
- Gaskin CM, Helms CA (2006) Parsonage-Turner syndrome: MR imaging findings and clinical information of 27 patients. Radiology.
- Tsairis P, Dyck PJ, Mulder DW (1972) Natural history of brachial plexus neuropathy.
- Van Alfen N, van Engelen, BG (2006) The clinical spectrum of neuralgic amyotrophy in 246 cases.