Fritz R C, Helms C A, Steinbach L S, Genant H K
Department of Radiology, University of California, San Francisco.
Radiology. 1992 Feb;182(2):437-44. doi: 10.1148/radiology.182.2.1732962.
Entrapment of the suprascapular nerve is frequently overlooked in the differential diagnosis of shoulder pain. The diagnosis is typically not considered until patients develop severe weakness secondary to atrophy of the spinatus (spinous) musculature that the nerve supplies. Twenty-seven masses were identified adjacent to the suprascapular nerve on magnetic resonance (MR) images of the shoulder; there were 21 ganglion cysts, two synovial sarcomas, one Ewing sarcoma, one chondrosarcoma, one metastatic renal cell carcinoma, and one hematoma associated with a fracture. Atrophy of both the supraspinatus and infraspinatus muscles was seen in association with anteriorly located masses and proximal entrapment of the nerve in 11 cases (40%); isolated atrophy of the infraspinatus muscle was seen in association with posteriorly located masses and distal entrapment of the nerve in nine cases (33%). MR imaging may facilitate the diagnosis of suprascapular nerve entrapment in patients with shoulder pain of unclear origin when perineural masses and atrophy of the spinatus musculature are present.
肩胛上神经卡压在肩痛的鉴别诊断中常被忽视。通常直到患者因该神经所支配的冈上（棘）肌萎缩继发严重无力时才会考虑该诊断。在肩部磁共振（MR）图像上，在肩胛上神经旁发现了27个肿块；其中有21个腱鞘囊肿、2个滑膜肉瘤、1个尤因肉瘤、1个软骨肉瘤、1个肾细胞癌转移灶以及1个与骨折相关的血肿。11例（40%）患者的冈上肌和冈下肌萎缩与位于前方的肿块及神经近端卡压有关；9例（33%）患者的冈下肌孤立性萎缩与位于后方的肿块及神经远端卡压有关。当存在神经周围肿块和冈上肌萎缩时，MR成像可能有助于诊断不明原因肩痛患者的肩胛上神经卡压。
