Identification of Ganglion cyst causing suprascapular nerve neuropathy by high resolution neurosonography

ABSTRACT

Suprascapular neuropathy is a rare cause of non-specific shoulder pain affecting all age groups. Magnetic resonance imaging is the most common modality utilized to investigate the cause of suprascapular neuropathy. We report here a case of 22 year old man who presented with diffuse right shoulder region pain and severe wasting of the right infraspinatus muscle of 2 months duration. He was engaged in regular overhead activities at a gymnasium for about 2 years. A possible diagnosis of suprascapular nerve entrapment was considered. The patient was investigated with high resolution neurosonography, which showed a ganglion (paralabral) cyst at the spinoglenoid notch compressing the suprascapular nerve. We propose the use of neurosonography as an economical and effective tool for initial screening of non-specific shoulder pain with or without wasting/weakness of scapular muscles. An early identification of the cause of the neuropathy prior to the onset of muscle weakness/ wasting, and therapeutic intervention is able to avoid permanent disability