Suprascapular neuropathy: Difference between revisions
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==Background== | ==Background== | ||
[[File:Gray808.png|thumb|The right brachial plexus with its short branches, viewed from anterior view. (Suprascapular labeled at upper left.)]] | |||
[[File:Gray810.png|thumb|Suprascapular and axillary nerves of right side, seen from posterior view.]] | |||
*Suprascapular nerve (C5, 6) branches from the superior trunk and innervates the supraspinatus and infraspinatus nerves | *Suprascapular nerve (C5, 6) branches from the superior trunk and innervates the supraspinatus and infraspinatus nerves | ||
*Compression of the nerve in the suprascapular notch (proximal, supraspinatus and infraspinatus affected) or at spinoglenoid ligament (distal, only infraspinatus affected)<ref>https://www.orthobullets.com/shoulder-and-elbow/3063/suprascapular-neuropathy?expandLeftMenu=true</ref><ref>Boykin RE et al. Suprascapular Neuropathy. JBJS. 2010;92:2348-2368.</ref> | *Compression of the nerve in the suprascapular notch (proximal, supraspinatus and infraspinatus affected) or at spinoglenoid ligament (distal, only infraspinatus affected)<ref>https://www.orthobullets.com/shoulder-and-elbow/3063/suprascapular-neuropathy?expandLeftMenu=true</ref><ref>Boykin RE et al. Suprascapular Neuropathy. JBJS. 2010;92:2348-2368.</ref> | ||
*Most often seen in athletes due to repetitive overhead arm movements | *Most often seen in athletes due to repetitive overhead arm movements | ||
== | ==Causes== | ||
*Structural (direct nerve compression) | *Structural (direct nerve compression) | ||
**Paralabral cyst | **Paralabral cyst | ||
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*Iaotrogenic | *Iaotrogenic | ||
== | ==Clinical Features== | ||
*Shoulder pain | |||
*Weakness of shoulder abduction, flexion, and internal rotation | |||
*May see atrophy of supraspinatus and infraspinatus muscles | |||
==== | ==Differential Diagnosis== | ||
{{Upper extremity peripheral nerve syndromes}} | |||
==Evaluation== | ==Evaluation== | ||
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==See Also== | ==See Also== | ||
*[[Peripheral nerve syndromes]] | |||
==External Links== | ==External Links== | ||
Revision as of 18:10, 5 August 2020
Background
- Suprascapular nerve (C5, 6) branches from the superior trunk and innervates the supraspinatus and infraspinatus nerves
- Compression of the nerve in the suprascapular notch (proximal, supraspinatus and infraspinatus affected) or at spinoglenoid ligament (distal, only infraspinatus affected)[1][2]
- Most often seen in athletes due to repetitive overhead arm movements
Causes
- Structural (direct nerve compression)
- Paralabral cyst
- Bone/soft tissue tumor
- Trauma
- Traction injury
- Rotator cuff tear
- Glenohumerol dislocation
- Scapular fracture
- Penetrating injury
- Autoimmune
- Iaotrogenic
Clinical Features
- Shoulder pain
- Weakness of shoulder abduction, flexion, and internal rotation
- May see atrophy of supraspinatus and infraspinatus muscles
Differential Diagnosis
Upper extremity peripheral nerve syndromes
Median Nerve Syndromes
Ulnar Nerve Syndromes
Radial Nerve Syndromes
- Radial neuropathy at the spiral groove (ie. "Saturday night palsy")
- Posterior interosseous neuropathy
Proximal Neuropathies
- Suprascapular neuropathy
- Long thoracic neuropathy
- Axillary neuropathy
- Spinal accessory neuropathy
- Musculocutaneous neuropathy
Other
Evaluation
- See Shoulder (Tests)
- Plain films to evaluate for fracture, callus, or bone tumor
- MRI and EMG outpatient
Management
- Nonoperative - activity modification, avoid overhead activities, physical therapy, NSAIDs, sling
- Operative for space occupying lesions
Disposition
- Discharge with orthopedic follow up
See Also
External Links
References
- ↑ https://www.orthobullets.com/shoulder-and-elbow/3063/suprascapular-neuropathy?expandLeftMenu=true
- ↑ Boykin RE et al. Suprascapular Neuropathy. JBJS. 2010;92:2348-2368.