Presentation
Left shoulder pain and weakness for the last few months. No trauma.
Patient Data
Subchondral sclerosis involving the greater tuberosity of the humeral head. No fracture/ dislocation/ bone lesion. No soft tissue calcification.
The rotator cuff tendons show normal echopattern. There is no tear/ tendinosis/ calcification. There is no effusion in the subacromial-subdeltoid bursa or glenohumeral joint. There is a thin-walled anechoic cyst in the spinoglenoid notch, which is also extending in the infraspinatous fossa. The infraspinatus muscle on the symptomatic side shows increased echogenicity and reduced volume in comparison to ipsilateral supraspinatus, teres minor muscles, and contralateral infraspinatus muscle. There is no lesion in the region of the suprascapular notch. The suprascapular nerve itself could not be identified in the scan.
Case Discussion
The patient presented with a non-traumatic onset of the left shoulder pain with a weakness for the last few months. The ultrasound shows the presence of a spinoglenoid notch cyst which is a direct sign of the suprascapular neuropathy. Infraspinatus muscle fatty infiltration and volume loss are the secondary signs of the compression neuropathy.
If the nerve compression occurs in the suprascapular notch, both supraspinatus and infraspinatus muscles show atrophy.
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