shoulder

Winged Scapula

 

Classification

 

Primary

 

Due to scapulothoracic articulation disorder

 

1.  Neurological Origin

 

A.  Spinal Accessory Nerve / Trapezius palsy

B.  Long Thoracic Nerve /  Serratus Anterior palsy

C.  Dorsal Scapular Nerve / Rhomboids palsy (rare)

 

2.  Osseous Origin

 

Axillary Nerve Lesions

Anatomy

 

Terminal branch of the posterior cord

- lateral to radial nerve

- behind axillary artery

- runs over inferolateral border of SSC

- enters quadrangular space

 

Quadrangular space

- SSC superiorly anterior

- T major inferior

- T minor superiorly posterior

- long head triceps and humerus

 

Divides into anterior and posterior branches

 

Adhesive capsulitis

Definition 

 

Idiopathic inflammatory condition

- characterised by progressive shoulder pain & stiffness

- due to contracture of capsuloligamentous structures

- spontaneously resolves 

 

Epidemiology

 

2% incidence

- 40 - 60 years

- Women 2:1

 

Sedentary workers

- Non-dominant limb

 

Bilateral in 10 - 40%

 

Aetiology

 

Avascular necrosis

Shoulder AVN

 

Epidemiology

 

Much less common than hip OA

- usually presents late

 

Aetiology

 

Similar causes as hip (AS IT GRIPS 3C)

 

Alcohol / Steroid / Trauma / Idiopathic

 

Gauchers

 

RA / RTx

 

Sickle Cell