Ganglion cysts about the shoulder girdle in the absence of suprascapular nerve involvement.

Ganglion cysts about the shoulder girdle are being identified with increasing frequency by the magnetic resonance image scanner. These masses rarely become evident clinically unless they cause compression of the suprascapular nerve. In this series a ganglion not causing compression of the suprascapular nerve was identified in each of five patients. Three of these patients had shoulder pain, tenderness over the supraspinotus muscle, and an increase in pain with abduction in the plane of the scapula. Plain radiographs showed erosion of the scapular neck. In the remaining two patients the pain pattern was consistent with an impingement syndrome in one and a rotator cuff tear in the other. Successful operative resection was undertaken on three patients. In two of these patients the magnetic resonance image scan helped determine the need for simultaneous exposure of the suprospinous and infraspinous fossae by means of scapular spine osteotomy. In the two patients not believed to be symptomatic from their ganglia, treatment for the primary shoulder diagnosis resulted in complete relief of symptoms. In the absence of suprascapular nerve involvement, the presence of a ganglion cyst in the shoulder girdle is not an absolute indication for operative resection. In the presence of another common shoulder diagnosis, treatment for that diagnosis should be pursued.