Suprascapular nerve entrapment

Case contributed by Dr Yasser Asiri

Presentation

Right shoulder gradually increasing pain for 3 months, no history of trauma.

Patient Data

Age: 35 years old
Gender: Female
Ultrasound

US Shoulder

There is mild thickening of supraspinatus tendon, which most likely related to mild tendinosis; however, there is no definite tear. The infraspinatus and subscapularis tendons appear within normal limits with no evidence of tendinosis or tear. Normal position and echogenicity of long head of biceps tendon.

Nonvisualization of posterior labrum with possible area of fragmented labral tissue is seen. There is adjacent large cystic lesion seen at spinoglenoid notch. No evidence of internal vascularity within the cystic lesion. The findings most likely represent labral tear with paralabral cyst formation (The patient also complain of clicking sound during shoulder movement).  Constellation of imaging findings and patient's history of clicking sound, are most likely represent labral tear with paralabral cyst.

MRI

MRI shoulder arthrogram

There is superior posterior labral tear with tracking of contrast through the tear and partially filling a large spinoglenoid cyst extending to the suprascapular notch. The findings are representing SLAP tear with adjacent paralabral cyst. There are associated moderate atrophic changes seen in the supraspinatus and infraspinatus muscles. The subscapularis and teres minor appear unremarkable.

Case Discussion

This case illustrates the typical pattern of denervation changes and muscular atrophy caused by suprascapular nerve entrapment at the level of suprascapular notch. 

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Case information

rID: 65698
Published: 16th Feb 2019
Last edited: 21st Feb 2019
Inclusion in quiz mode: Included

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