Kim Jung Ryul, Wang Sung Il
Department of Orthopaedics Surgery, Chonbuk National University Medical School, Research Institute for Endocrine Sciences and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.
Medicine (Baltimore). 2017 Jun;96(24):e7167. doi: 10.1097/MD.0000000000007167.
Suprascapular nerve compression is a rare but important entity that is often missed in clinical practice. Nerve dysfunction caused by an intraosseous ganglion of the glenoid is extremely rare, to the best of our knowledge, only 1 case of suprascapular nerve entrapment due to an intraosseous ganglion cyst has been reported previously in the published literature.
We report a 61-year-old woman who had complained right shoulder pain that lasted over 3 years which was exacerbated by overhead activities.
We diagnosed it as suprascapular nerve entrapment at the spinoglenoid notch caused by an intraosseous ganglion of the scapula.
Plain X-ray, computed tomography, magnetic resonance imaging (MRI), and electromyography (EMG) of the shoulder.
She undertook surgical excision with curettage of the cyst. The infraspinatus fossa dull pain subsided immediately after surgery. No recurrence of the cystic lesion was noted on follow-up plain radiograph and MRI performed 18 months postoperatively. Shoulder external rotation strength was graded as 5 of 5.
Intraosseous ganglion of the glenoid can cause compression of the suprascapular nerve when the lesion is expanded toward the spinoglenoid notch. The EMG study confirmed compression of the suprascapular nerve. The patient showed clinical and radiologic improvement after surgical decompression with no recurrence.
肩胛上神经受压是一种罕见但重要的病症，在临床实践中常被漏诊。据我们所知，由肩胛盂骨内腱鞘囊肿引起的神经功能障碍极为罕见，此前在已发表的文献中仅报道过1例因骨内腱鞘囊肿导致的肩胛上神经卡压病例。
我们报告了一名61岁女性，她主诉右肩疼痛持续超过3年，上肢上举活动时疼痛加剧。
我们诊断为肩胛上神经在肩胛冈下切迹处受压，由肩胛骨骨内腱鞘囊肿引起。
肩部的X线平片、计算机断层扫描、磁共振成像（MRI）和肌电图（EMG）检查。
她接受了囊肿刮除手术切除。术后冈下窝钝痛立即缓解。术后18个月的随访X线平片和MRI检查未发现囊性病变复发。肩部外旋力量评级为5级（满分5级）。
当肩胛盂骨内腱鞘囊肿病变向肩胛冈下切迹扩展时，可导致肩胛上神经受压。肌电图研究证实了肩胛上神经受压。手术减压后患者临床和影像学表现均有改善，且无复发。
