Atrophy of the infraspinatus muscle as a result of atraumatic isolated suprascapular neuropathy: a case report and review of the literature/ Infraspinatus kasinda atrofiye neden olan atravmatik izole supraskapular sinir hasari: olgu sunumu ve literaturun gozden gecirilmesi

Summary Suprascapular neuropathy may occur as a result of traction, direct trauma, repetitive overhead activities, extrinsic compression and iatrogenic causes. The cases have been reported in the literature usually seen after trauma in athletes and young people. However, in chronic cases or in elderly people, a history of trauma may not always be necessary. Here, we present a 59-year-old sedentary male with a 3-month history of atraumatic posterior shoulder pain and weakness. Initially, he was misdiagnosed at several other clinics as periarthritis of the shoulder. A detailed physical examination showed atrophy of the infraspinatus muscle. Electrophysiolgic studies of the right upper extremity revealed normal peripheral nerve conduction parameters except for prolonged Erb latency recorded from the infraspinatus muscle. Electromyography showed spontaneous activity and reduced recruitment in the infraspinatus muscle, while supraspinatus muscle was normal. Magnetic resonance imaging demonstrated posterior labral tear and a paralabral synovial cyst extending to the infraspinatus muscle as well as edema in the infraspinatus muscle consistent with denervation. The patient, who did not benefit from conservative therapy, was referred for surgery. Suprascapular neuropathy resulting in isolated weakness and atrophy of the infraspinatus muscle could be challenging at its onset and electrophysiologic evaluation is essential for the differential diagnosis. Key Words: Suprascapular neuropathy, rehabilitation, electrophysioloy, shoulder pain Ozet Supraskapular sinir sikismasi traksiyon, direkt travma, tekrarlayan mikrotravmalar, kitle lezyonu ve iyatrojenik sebepler sonrasi gorulebilir. Literaturde genellikle sporcularda ve genclerde travma sonrasi gorulen olgular bildirilmistir. Ancak kronik durumlarda ve yaslilarda travma oykusu her zaman bulunmayabilir. Burada 59 yasinda, travma olmaksizin ortaya cikan ve 3 aydir artan siddette sag omuz agrisi ve kuvvet kaybi sikayeti ile klinigimize basvuran bir erkek hasta sunulmaktadir. Farkli merkezlerde omuz periartriti olarak degerlendirilen ve konservatif tedavilerden fayda gormeyen hastanin detayli fizik muayene sonucunda sag infraspinatus kasinda atrofi saptanmasi uzerine yapilan ust ekstremite elektronoromiyografisinde, sag infraspinatus kasindan kayitla uzamis sag supraskapular sinir Erb latansi ve infraspinatus kasinda denervasyon bulgulari saptandi; supraspinatus kasi korunmustu. Cekilen manyetik rezonans goruntuleme sonuc