Atrophy of the Infraspinatus Muscle as A Result of Atraumatic Isolated Suprascapular Neuropathy: A Case Report and Review of the Literature
Suprascapular neuropathy may occur as a result of traction, direct trauma, repetitive overhead activities, extrinsic compression and iatrogenic causes. The cases have been reported in the literature usually seen after trauma in athletes and young people. However, in chronic cases or in elderly people, a history of trauma may not always be necessary. Here, we present a 59-year-old sedentary male with a 3-month history of atraumatic posterior shoulder pain and weakness. Initially, he was misdiagnosed at several other clinics as periarthritis of the shoulder. A detailed physical examination showed atrophy of the infraspinatus muscle. Electrophysiolgic studies of the right upper extremity revealed normal peripheral nerve conduction parameters except for prolonged Erb latency recorded from the infraspinatus muscle. Electromyography showed spontaneous activity and reduced recruitment in the infraspinatus muscle, while supraspinatus muscle was normal. Magnetic resonance imaging demonstrated posterior labral tear and a paralabral synovial cyst extending to the infraspinatus muscle as well as edema in the infraspinatus muscle consistent with denervation. The patient, who did not benefit from conservative therapy, was referred for surgery. Suprascapular neuropathy resulting in isolated weakness and atrophy of the infraspinatus muscle could be challenging at its onset and electrophysiologic evaluation is essential for the differential diagnosis.
Keywords : Suprascapular neuropathy, rehabilitation, electrophysioloy,shoulder pai