Parsonage turner syndrome

Case contributed by Dr Abeer Ahmed Alhelali

Presentation

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.

Patient Data

Age: 50-year-old
Gender: Male
Modality: MRI

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.

Case Discussion

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.

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Case Information

rID: 49793
Case created: 4th Dec 2016
Last edited: 15th Dec 2016
Inclusion in quiz mode: Excluded

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