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"The Shoulder" Demo

Suprascapular nerve palsy

Clinical presentation
Constant pain in the trapezius and scapular area for about three weeks followed by functional disturbances in the arm ( difficulties to perform overhead activities)

Functional examination of the shoulder
Painless weakness of abduction (supraspinatus) and gross but painless weakness of lateral rotation (infraspinatus).

Causes
The majority of suprascapular nerve lesions reported have been in the area involving the transverse scapular ligament Chronic mechanical irritation may be caused by overhead activities such as racket sports, lifting and volleyball playing.
Isolated infraspinatus muscle paralysis has been found in volleyball players as a result of cocking of the arm.
Also a direct trauma, a compression (backpacking) or a fracture of the scapula may cause the lesion.
Sometimes a 'viral neuritis' is hold responsible for a palsy of the suprascapular nerve.

Natural History

  • Spontaneous cure is the rule in a 'neuritis'.
  • The pain disappears within three weeks, weakness within 6 - 12 months

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