Gregory Thomas, Sangha Harpreet, Bleakney Robert
From the University of Toronto (TG); Toronto Rehabilitation Institute, The University Centre (HS); and Mount Sinai Hospital and the University Health Network, Department of Medical Imaging, Toronto, Ontario, Canada (RB).
Am J Phys Med Rehabil. 2015 Jan;94(1):e1-5. doi: 10.1097/PHM.0000000000000237.
A case of quadrilateral space syndrome is presented, where a large near-circumferential glenoid labrum tear led to a paralabral cyst that dissected into the quadrilateral space and caused a compressive neuropathy of the axillary nerve. This led to a 6-mo history of left shoulder pain, parasthesias, marked weakness to abduction, and marked denervation in both the deltoid and teres minor on electro-diagnostics. This is a presentation of interest as it is the only case report in the literature, to the authors' knowledge, where spontaneous resolution of entrapment occurred. This normally requires intervention for definitive management. It resolved through nonsurgical management with pregabalin, oxycodon, and naproxen medications, leading to good functional return, as well as pain and presumed muscle edema dissipation, while awaiting interventional consultation. It also illustrates that quadrilateral space syndrome is a difficult clinical diagnosis owing to the nonspecific symptom presentation, as well as weakness.
