Suprascapular neuropathy
Background
The right brachial plexus with its short branches, viewed from anterior view. (Suprascapular labeled at upper left.)
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
- 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
- Carpal tunnel syndrome
- Pronator teres syndrome
- Anterior interosseous neuropathy
Ulnar Nerve Syndromes
- Ulnar neuropathy at the elbow and wrist
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
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.
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