Akgun Kenan, Aktas Ilknur, Terzi Yeliz
Department of Physical Medicine and Rehabilitation, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
Arch Phys Med Rehabil. 2008 Oct;89(10):2017-20. doi: 10.1016/j.apmr.2008.03.015.
Dorsal scapular nerve lesions are quite rare. A case of a 51-year-old man who had right shoulder pain, weakness of right arm elevation, and prominence of right scapula for 6 months is presented. The condition had been abruptly developed after lifting a heavy box overhead on which he felt a sharp pain in the right shoulder. On clinical examination, there was a prominence of the lower medial border and inferior angle of the right scapula compared with the left. In addition, the right scapula was located more lateral. Magnetic resonance imaging of the thorax revealed the presence of a thinner rhomboid major muscle with a pathologic signal compared with the other side. Needle electromyography of the right rhomboid muscle revealed a long duration, polyphasic motor unit potential with reinnervation potentials, and spontaneous activity. According to these findings, the patient was diagnosed as having a winged scapula because of dorsal scapular nerve lesion.
肩胛背神经损伤相当罕见。本文报告一例51岁男性患者，其右肩疼痛、右臂上举无力及右肩胛骨突出6个月。该情况在将一个沉重的箱子举过头顶后突然出现，当时他感到右肩剧痛。临床检查发现，与左侧相比，右肩胛骨的下内侧缘和下角突出。此外，右肩胛骨位置更偏外侧。胸部磁共振成像显示，与另一侧相比，菱形大肌较薄且有病理信号。右侧菱形肌的针极肌电图显示运动单位电位持续时间长、多相，伴有再支配电位和自发电活动。根据这些发现，该患者被诊断为肩胛背神经损伤导致的翼状肩胛。
