Quadrangular space syndrome

Case contributed by Dr Piyush P Siwach

Presentation

Neck pain, left shoulder pain.

Patient Data

Age: 50 years
Gender: Female
MRI

Severe fatty atrophy of the teres minor muscle.

No mass or varices in the quadrangular space.

Unrelated to the other pathology, superior labral tear from 10 to 3 o'clock position and minor glenoid chondromalacia anteriorly and mild subacromial-subdeltoid bursitis.

Annotated image

Annotated images from the MRI highlighting the Teres minor muscle and quadrangular space.

Case Discussion

The pattern of atrophy of the teres minor muscle is consistent with chronic denervation. The tendon of teres minor is intact, and tears of this tendon are uncommon even in large rotator cuff tears. Quadrangular space is the site most likely to cause axillary nerve impingement resulting in this abnormality. A higher lesion is excluded as the deltoid muscle is normal in volume and signal intensity. In this case atrophy of the muscle is terminal and beyond the stage of surgical decompression of the space. 

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Case information

rID: 53525
Case created: 22nd May 2017
Last edited: 30th May 2017
Inclusion in quiz mode: Included

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