Suprascapular Neuropathy

Author: David Abbasi

Topic updated on 04/15/13 11:49am

Introduction

Can be caused by
- suprascapular notch entrapment
  - weakness of both supraspinatus and infraspinatus
- spinoglenoid notch entrapment
  - weakness of infraspinatus only

Anatomy

Suprascapular nerve (C5,C6)
- emerges off superior trunk (C5,C6) of brachial plexus
- travels across posterior triangle of neck to scapula
- innervates
  - supraspinatus
  - infraspinatus
Suprascapular ligament
- arises from medial base of coracoid and overlies suprascapular notch
  - suprascapular artery runs above
  - suprascapular nerve runs below
Spinoglenoid ligament
- arises near spinoglenoid notch
  - overlies distal suprascapular nerve

Suprascapular notch entrapment

Introduction
- proximal compression of suprascapular nerve in the suprascapular notch
  - leads to weakness of both supraspinatus and infraspinatus
Pathoanatomy
- compression can be from
  - ganglion cyst (often associated with labral tears)
  - transverse scapular ligament entrapment
  - fracture callus
Presentation
- symptoms
  - deep, diffuse, posterolateral shoulder pain
- physical exam
  - pain with palpation of suprascapular notch
  - weakness of supraspinatus
    - weakness seen with shoulder abduction to 90 degree, 30 degrees forward flexion, and with internal rotation (Jobe test positive)
  - weakness of infraspinatus
    - weakness to external rotation with elbow at side
  - atrophy along the posterior scapula
Evaluation
- MRI
  - important to identify a compressive mass with associated cyst
- EMG/NCV
  - diagnostic
Treatment
- nonoperative
  - activity modification and organized shoulder rehab program
    - indications
      - no structural lesion seen on MRI
    - technique
      - rehab should be performed for a minimum of six months
- operative
  - surgical nerve decompression at suprascapular notch
    - indications
      - structural lesion seen on MRI (cyst)
      - failure of extended nonoperative management (~ 1 year)

Spinoglenoid notch entrapment

Introduction
- distal compression of suprascapular nerve
  - affects infraspinatus only
- Pathoanatomy
  - compression can be due to
    - posterior labral tears causing a cyst
    - spinoglenoid ligament
    - spinoglenoid notch ganglion
    - traction injury (seen in 45% of volley ball players)
Presentation
- symptoms
  - deep, diffuse, posterolateral shoulder pain
- physical exam
  - infraspinatus weakness
    - weakness to external rotation with elbow at side
  - infraspinatus atrophy along the posterior scapula
  - supraspinatus strength is normal
Evaluation
- MRI
  - important to identify posterior labral lesions with associated cyst
- EMG/NCV
  - diagnostic
Treatment
- nonoperative
  - activity modification and organized shoulder rehab program
    - indications
      - no structural lesion seen on MRI
    - technique
      - posterior shoulder capsule stretching
- operative
  - arthroscopic cyst decompression and labral repair
    - indications
      - labral lesion with associated cyst seen on MRI
  - spinoglenoid ligament release with nerve decompression
    - indications
      - no structural lesion seen on MRI and failure of extended nonoperative management (~ 1 year)
    - technique
      - posterior approach commonly utilized
      - decompress nerve in spinoglenoid notch

Please Rate Educational Value!

4.0

Average 4.0 of 10 Ratings

Qbank (8 Questions)

TAG

(SBQ07.51) A 34-year-old competitive weightlifter presents with increasing pain during bench pressing. His physical exam demonstrates slight weakness in external rotation. Radiographs are unremarkable. His MRI findings are seen in Figure A. Treatment should include which of the following? Topic

Review Topic

FIGURES: A

1. Refrain from weightlifting for a minimum of 6 weeks
2. Physical therapy with rotator cuff strengthening
3. Suprascapular cyst decompression
4. Infraspinatus rotator cuff repair and acromioplasty
5. Spinoglenoid cyst decompression with posterior labral repair

PREFERRED RESPONSE ▶

DISCUSSION: The clinical and MRI findings in the stem are consistent with a posterior labral tear and associated spinoglenoid cyst. A spinoglenoid cyst could cause nerve compression on the suprascapular nerve before its innervation to the infraspinatus, thus causing weakness in external rotation. In contrast, compression at the suprascapular notch would affect both the supraspinatus and infraspinatus muscles. The suggested treatment in a young and competitive athlete with a spinoglenoid cyst would be spinoglenoid cyst decompression with posterior labral repair.

Cummins et al studied suprascapular nerve entrapement and concluded that treatment should be directed toward the underlying cause of the nerve injury. Nonoperative management showed a high rate of failure in the treatment of ganglion cysts. Operative decompression of the suprascapular nerve was associated with a high rate of pain relief and functional improvement. However, resolution of muscle atrophy was less predictable.

Martin et al looked at the results of nonoperative treatment for suprascapular neuropathy confirmed by EMG. Their results suggest that in the absence of a well defined lesion producing mechanical compression of the suprascapular nerve, suprascapular neuropathy could be treated non-operatively.

REFERENCES:

1. Cummins CA, Messer TM, Nuber GW: Suprascapular nerve entrapment. J Bone Joint Surg Am 2000;82:415-424. PMID:10724234 (Link to Abstract)

2. Martin SD, Warren RF, Martin TL, et al: Suprascapular neuropathy: Results of non-operative treatment. J Bone Joint Surg Am 1997;79:1159-1165. PMID:9278075 (Link to Abstract)

Question Authors:

David Abbasi MD, Michael Hughes MD, John Badylak MD, Eric Shirley MD,

Please Rate Educational Value!

4.0

Average 4.0 of 2 Ratings

TAG

(OBQ11.179) A 44-year-old male presents with a 2 month history of posterior shoulder pain. He is noted to have normal forward flexion and abduction strength and isolated weakness on shoulder external rotation. He has slight atrophy of his periscapular area. He has no numbness or paraesthesias. Which pathology would best explain his symptoms? Topic

Review Topic

1. Cranial nerve XI palsy
2. Spinoglenoid notch cyst
3. Axillary nerve palsy
4. Suprascapular notch cyst
5. Parsonage-Turner Syndrome

PREFERRED RESPONSE ▶

DISCUSSION: This patients exhibits weakness with shoulder external rotation. Entrapment of the suprascapular nerve at the spinoglenoid notch would cause isolated infraspinatus muscle weakness and atrophy in the infraspinatus fossa. A cyst at the suprascapular notch also involves the suprascapular nerve, however more proximally. Pathology at this site would involve both the supraspinatus and infraspinatus, and the patient would also have weakness with shoulder abduction along with external rotation.

Warner et al, in their anatomical study, studied the relationship of the suprascapular nerve as it courses along the scapula. They comment on the course of the suprascapular nerve as it runs obliquely across the supraspinatus fossa underneath the transverse scapular ligament.

Piasecki et al performed a study on suprascapular neuropathy. They note that the suprascapular nerve follows a tortuous course from the neck to the posterior shoulder and can have several sites of entrapment: particularly at the vulnerable suprascapular and spinoglenoid notches. They recommend nerve decompression after failure of nonsurgical measures by either arthroscopic or open surgery.

Illustration A shows the course of the suprascapular notch along the scapula. Illustration B and C show axial and sagittal MRI images of a spinoglenoid cyst causing compression on the suprascapular nerve. This patient had isolated infraspinatus symptoms. Illustration V is a comprehensive video reviewing suprascapular neuropathy and surgical treatment.

Illustrations: A

REFERENCES:

1. Warner JP, Krushell RJ, Masquelet A, Gerber C. Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Joint Surg Am. 1992 Jan;74(1):36-45. PMID:1734012 (Link to Abstract)

2. Piasecki DP, Romeo AA, Bach BR Jr, Nicholson GP. Suprascapular neuropathy. J Am Acad Orthop Surg. 2009 Nov;17(11):665-76. PMID:19880677 (Link to Abstract)

Question Authors:

David Abbasi MD, Jeremy Stern MD, Patrick McCulloch MD,

Please Rate Educational Value!

4.0

Average 4.0 of 8 Ratings

TAG

(OBQ10.168) A 29-year-old male volleyball player presents with a one year history of right shoulder weakness and deep aching pain. He denies any history of trauma or prior shoulder problems. A clinical photograph and representative MRI image are shown in Figures A and B respectively. He is diagnosed with a ganglion cyst of the shoulder. Based on the images provided, where is the cyst located? Topic

Review Topic

FIGURES: A

1. Suprascapular notch
2. Spinoglenoid notch
3. Quadrangular space
4. Subscapular recess
5. Triangular interval

PREFERRED RESPONSE ▶

DISCUSSION: This patient has a spinoglenoid notch cyst which is causing compression of the distal branches of the suprascapular nerve and the isolated infraspinatus atrophy shown in Figures A and B. Suprascapular nerve innervation to the supraspinatous m. occurs before the nerve enters the spinoglenoid notch, and therefore cysts occuring at the spinoglenoid notch cause denervation and atrophy of the infraspinatous only. Ganglion cysts more proximally at the suprascapular notch affect both the supraspinatous and infraspinatous, shown in Illustration A. Suprascapular nerve compression can often result in vague shoulder pain and muscle weakness, particularly with overhead activities. The quadrangular space contains the axillary nerve and posterior humeral circumflex artery, while the contents of the triangular interval include the radial nerve and profunda brachii artery. The anatomic boundaries of this space and interval are shown in Illustration B. Compression at either of these locations would not affect the infraspinatous muscle. Safran's review article discusses the anatomy, pathophysiology, presentation, and treatment of suprascapular and axillary nerve injuries about the shoulder in athletes. Cummins et al provide a Current Concepts Review which summarizes the relevant literature to date regarding the pathoanatomy of the suprascapular nerve and its clinical relevance.

Illustrations: A

REFERENCES:

1. Safran MR. Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med. 2004 Apr-May;32(3):803-19. PMID:15090401 (Link to Abstract)

2. Cummins CA, Messer TM, Nuber GW. Suprascapular nerve entrapment. J Bone Joint Surg Am. 2000 Mar;82(3):415-24. PMID:10724234 (Link to Abstract)

Question Authors:

Joshua Blomberg MD, Patrick McCulloch MD, Patrick McCulloch MD,

Please Rate Educational Value!

3.0

Average 3.0 of 11 Ratings

TAG

(OBQ07.107) A patient with shoulder pain and weakness has an MRI showing a cyst in the suprascapular notch. Which of the following muscles is most likely to show weakness? Topic

Review Topic

1. Deltoid
2. Supraspinatus
3. Supraspinatus and infraspinatus
4. Infraspinatus
5. Teres minor

PREFERRED RESPONSE ▶

DISCUSSION: The suprascapular notch is proximal to the point where the suprascapular nerve innervates both the supraspinatus and the infraspinatus, therefore compression would cause weakness of both.

Compression at the spinoglenoid notch will affect only the infraspinatus as the suprascapular nerve has already innervated the supraspinatus by this point. The teres minor and deltoid are both innervated by the axillary nerve. The axillary nerve passes through the quadrangular space and compression here could result in denervation of the posterior deltoid. Spinoglenoid notch cysts are classically seen in volleyball players and associated with SLAP tears.

Martin et al review the outcomes of 24 overhead athletes who underwent arthroscopic debridement of labral tears. Results were good to excellent in 21 of the 24 patients when there was no gross instability or Bankart lesion present.

Meister et al review the evaluation and treatment of the throwing athlete. Rotator cuff weakness, labral tears and paralabral cysts are discussed. Treatment is based on the pathoanatomy of the throwing shoulder, and most athletes will achieve successful rehabilitation with nonoperative care.

Illustration A demonstrates the anatomy of the suprascapular nerve and its sites of compression.

Illustrations: A

REFERENCES:

1. Martin DR, Garth WP: Results of arthroscopic debridement of glenoid labral tears. Am J Sports Med 1995;23:447-451 PMID:7573655 (Link to Abstract)

2. Meister K. Injuries to the shoulder in the throwing athlete. Part two: evaluation/treatment. Am J Sports Med. 2000 Jul-Aug;28(4):587-601. PMID:10921657 (Link to Abstract)

Question Authors:

Patrick McCulloch MD, Dave Marcu MD, Ben Taylor MD,

Please Rate Educational Value!

4.0

Average 4.0 of 6 Ratings

TAG

(OBQ05.15) A 21-year-old collegiate volleyball player is noted to have weakness in external rotation and isolated atrophy of the infraspinatus on physical examination as seen in Figure A. An axial MRI image is shown in Figure B. This clinical condition is most likely caused by compression of the: Topic

Review Topic

FIGURES: A

1. Musculocutaneous nerve in the subcoracoid region
2. Suprascapular nerve in the suprascapular notch
3. Axillary nerve in the quadrangular space
4. Suprascapular nerve in the spinoglenoid notch
5. Suprascapular artery in the suprascapular notch

PREFERRED RESPONSE ▶

DISCUSSION: The clinical presentation is consistent for a suprascapular neuropathy caused by compression of the suprascapular nerve by a cyst in the spinoglenoid notch. The suprascapular nerve arises from the upper trunk of the brachial plexus with contributions from C5-6. It travels through the suprascapular notch of the scapula where it gives motor branches to the supraspinatus then around the spinoglenoid notch where it innervates the infraspinatus. Compression of the nerve at the suprascapular notch will cause denervation and atrophy of both the supraspinatus and infraspinatus while compression at the spinoglenoid notch affects the infraspinatus in isolation. This is commonly seen in overhead athletes who sustain a SLAP tear and resultant spinoglenoid notch cyst as seen in the MRI. This will cause weakness and atrophy of the infraspinatus and can be noted both clinically and radiographically. Appropriate operative management is still not clear in the literature with some authors reporting a need for labral repair + cyst decompression and others reporting good outcomes with labral repair alone. Other cases have been treated with needle aspiration. The cited reference by Cummins et al reviews the various causes, diagnosis, and treatment of suprascapular neuropathy. The reference by Martin et al is a retrospective study of the results of non-operative treatment of suprascapular neuropathy in which 5 had excellent results and 7 had good results.

Illustrations: A

REFERENCES:

1. Cummins CA, Messer TM, Nuber GW. Suprascapular nerve entrapment. J Bone Joint Surg Am 2000;82:415-424. PMID:10724234 (Link to Abstract)

2. Martin SD, Warren RF, Martin TL, Kennedy K, O'Brien SJ, Wickiewicz TL. Suprascapular neuropathy. Results of non-operative treatment. J Bone Joint Surg. Am. 1997 Aug;79(8):1159-65. PMID:9278075 (Link to Abstract)

Question Authors:

Robert Boykin MD, Patrick McCulloch MD,

Please Rate Educational Value!

4.0

Average 4.0 of 6 Ratings

TAG

(OBQ05.202) A patient is scheduled to undergo arthroscopy for a SLAP tear of his shoulder. Based on the MRI shown in Figure A, what additional physical exam finding is the patient likely to display? Topic

Review Topic

FIGURES: A

1. weakness in forward elevation
2. weakness in internal rotation
3. weakness in external rotation
4. positive impingement maneuver
5. scapular winging

PREFERRED RESPONSE ▶

DISCUSSION: The MRI shows a cyst in the spinoglenoid notch, which is important to differentiate from a cyst in the suprascapular notch. A suprascapular cyst can impinge upon the suprascapular nerve prior to inneravation of the supraspinatus and infraspinatus muscle, leading to weakness in both muscles. Figure A shows a cyst in the spinoglenoid notch, where it may impinge on the suprascapular nerve as it travels around the glenoid and under the spine of the scapula on its way to innervate the infraspinatus muscle. Prolonged impingement on the suprascapular nerve by a spinoglenoid cyst can result in atrophy of the infraspinatus muscles. This would show up as weakness in external rotation on exam. These cysts are associated with SLAP lesions and per literature are formed by a one-way valve effect, where synovial fluid can exit the joint into the cyst but not drain spontaneously. Chen et al describe 3 cases in which preoperative and postoperative EMG's and MRI imaging documented cyst resolution and return of suprascapular nerve function after arthroscopic spinoglenoid cyst excision and labral repair.

REFERENCES:

1. Chen AL, Ong BC, Rose DJ. Arthroscopic management of spinoglenoid cysts associated with SLAP lesions and suprascapular neuropathy. Arthroscopy. 2003 Jul-Aug;19(6):E15-21. PMID:12861219 (Link to Abstract)

Question Authors:

Greg Galano MD, Derek Moore, Patrick McCulloch MD,

Please Rate Educational Value!

2.0

Average 2.0 of 10 Ratings

TAG

(OBQ04.127) A 25-year-old volleyball player has recurrent right shoulder pain. On exam she has right shoulder weakness to external rotation with her arm at her side and atrophy below the scapular spine. There is no external rotation lag sign. Jobe drop arm and Hornblowers tests are negative. The O'Brien's test is positive. What will most likely be found on MRI of her shoulder? Topic

Review Topic

1. Partial articular sided tear of the infraspinatus
2. Partial articular sided tear of the supraspinatus
3. Full thickness tear of the infraspinatus
4. Inferior labral tear with quadrangular space cyst
5. SLAP tear and spinoglenoid notch cyst

PREFERRED RESPONSE ▶

DISCUSSION: This is a classic case of suprascapular nerve impingment at the spinoglenoid notch, likely from a cyst associated with a posterior SLAP tear. Compression of the suprascapular nerve at the spinoglenoid notch causes isolated infraspinatus weakness while compression at the suprascapular notch would affect both the supraspinatus and infraspinatus. A posterior SLAP tear is suspected with a positive O'Brien's active compression test. The labral tear can allow cyst development in the spinoglenoid notch. Thompson et al first described the findings of suprascapular nerve entrapment by a spinoglenoid notch cyst and Fehrman et al confirmed six cases of these cysts associated with posterior capsulolabral injuries. The article by Piasecki et al reviews the diagnosis and treatment of suprascapular neuropathy. Illustration A shows a typical appearance of a spinoglenoid cyst on MRI.

Illustrations: A

REFERENCES:

1. Thompson RC Jr, Schneider W, Kennedy T. Entrapment neuropathy of the inferior branch of the suprascapular nerve by ganglia. Clin Orthop Relat Res. 1982 Jun;(166):185-7. PMID:7083670 (Link to Abstract)

2. Fehrman DA, Orwin JF, Jennings RM. Suprascapular nerve entrapment by ganglion cysts: a report of six cases with arthroscopic findings and review of the literature. Arthroscopy. 1995 Dec;11(6):727-34. PMID:8679037 (Link to Abstract)

3. Piasecki DP, Romeo AA, Bach BR Jr, Nicholson GP. Suprascapular neuropathy. J Am Acad Orthop Surg. 2009 Nov;17(11):665-76. Review. PMID:19880677 (Link to Abstract)

Question Authors:

Charles Jobin MD, Patrick McCulloch MD,

Please Rate Educational Value!

4.0

Average 4.0 of 10 Ratings

Videos

	Arthroscopic Suprascapular Nerve Decompression Sports - Surgical Techniques - Suprascapular Neuropathy Video shows presentation and technique arthroscopic suprascapular nerve decompre...	4/13/2013 58 views 4
	Suprascapular Nerve Decompression Sports - Surgical Technique - Suprascapular Neuropathy During this video, Dr. Millett discuss causes, symptoms and treatment for Supras...	4/10/2012 494 views 5

See More Videos

Groups

ABOS II: Suprascapular Neuropathy

General - Oral Boards Review

7/29/2011

0 responses

See More Groups

Evidence & References Show References

Textbooks

Review of Orthopaedics, 6th Edition, Mark D. Miller MD, Stephen R. Thompson MBBS MEd FRCSC, Jennifer Hart MPAS PA-C ATC, an imprint of Elsevier, Philadelphia, Copyright 2012
AAOS Comprehensive Orthopaedic Review, Jay R. Leiberman. Published by American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2009
Orthopaedic Knowledge Update 10, John M Flyn. Published by American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2011
Hoppenfeld SP. Surgical Exposures in Orthopaedics: The Anatomic Approach. Lipponcott, Williams, and Wilkins, Philadelphia, PA, Copyright 2009
Orthopaedic In-training Examination (OITE) Questions 2004-2012, American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2004-2012
Self-Assessment Examination (SAE) Questions 2004-2012, American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2004-2012

Undefined

Cummins CA, Messer TM, Nuber GW: Suprascapular nerve entrapment. J Bone Joint Surg Am 2000;82:415-424. PMID:10724234 (Link to Abstract)
Martin SD, Warren RF, Martin TL, et al: Suprascapular neuropathy: Results of non-operative treatment. J Bone Joint Surg Am 1997;79:1159-1165. PMID:9278075 (Link to Abstract)
Piatt BE, Hawkins RJ, Fritz RC, Ho CP, Wolf E, Schickendantz M. Clinical evaluation and treatment of spinoglenoid notch ganglion cysts. J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):600-4. PMID:12469086 (Link to Abstract)
Chen AL, Ong BC, Rose DJ. Arthroscopic management of spinoglenoid cysts associated with SLAP lesions and suprascapular neuropathy. Arthroscopy. 2003 Jul-Aug;19(6):E15-21. PMID:12861219 (Link to Abstract)
Warner JP, Krushell RJ, Masquelet A, Gerber C. Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Joint Surg Am. 1992 Jan;74(1):36-45. PMID:1734012 (Link to Abstract)
Piasecki DP, Romeo AA, Bach BR Jr, Nicholson GP. Suprascapular neuropathy. J Am Acad Orthop Surg. 2009 Nov;17(11):665-76. PMID:19880677 (Link to Abstract)
Safran MR. Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve. Am J Sports Med. 2004 Apr-May;32(3):803-19. PMID:15090401 (Link to Abstract)
Cummins CA, Messer TM, Nuber GW. Suprascapular nerve entrapment. J Bone Joint Surg Am. 2000 Mar;82(3):415-24. PMID:10724234 (Link to Abstract)
Martin DR, Garth WP: Results of arthroscopic debridement of glenoid labral tears. Am J Sports Med 1995;23:447-451 PMID:7573655 (Link to Abstract)
Meister K. Injuries to the shoulder in the throwing athlete. Part two: evaluation/treatment. Am J Sports Med. 2000 Jul-Aug;28(4):587-601. PMID:10921657 (Link to Abstract)
Cummins CA, Messer TM, Nuber GW. Suprascapular nerve entrapment. J Bone Joint Surg Am 2000;82:415-424. PMID:10724234 (Link to Abstract)
Martin SD, Warren RF, Martin TL, Kennedy K, O'Brien SJ, Wickiewicz TL. Suprascapular neuropathy. Results of non-operative treatment. J Bone Joint Surg. Am. 1997 Aug;79(8):1159-65. PMID:9278075 (Link to Abstract)
Mittal S, Turcinovic M, Gould ES, Vishnubhakat SM. Acute isolatedsuprascapular nerve palsy limited to the infraspinatus muscle: a case report.Arch Phys Med Rehabil. 2002 Apr;83(4):565-7. PMID:11932863 (Link to Abstract)
Romeo AA, Rotenberg DD, Bach BR Jr. Suprascapular neuropathy. J Am Acad OrthopSurg. 1999 Nov-Dec;7(6):358-67. PMID:11497489 (Link to Abstract)
Chen AL, Ong BC, Rose DJ. Arthroscopic management of spinoglenoid cysts associated with SLAP lesions and suprascapular neuropathy. Arthroscopy. 2003 Jul-Aug;19(6):E15-21. PMID:12861219 (Link to Abstract)
Thompson RC Jr, Schneider W, Kennedy T. Entrapment neuropathy of the inferior branch of the suprascapular nerve by ganglia. Clin Orthop Relat Res. 1982 Jun;(166):185-7. PMID:7083670 (Link to Abstract)
Fehrman DA, Orwin JF, Jennings RM. Suprascapular nerve entrapment by ganglion cysts: a report of six cases with arthroscopic findings and review of the literature. Arthroscopy. 1995 Dec;11(6):727-34. PMID:8679037 (Link to Abstract)
Piasecki DP, Romeo AA, Bach BR Jr, Nicholson GP. Suprascapular neuropathy. J Am Acad Orthop Surg. 2009 Nov;17(11):665-76. Review. PMID:19880677 (Link to Abstract)

Topic Comments

Subscribe status: On Off

Recent on Bottom | Recent on Top

Page:1

Suprascapular Neuropathy

Qbank (8 Questions)

Question Comments

Question Comments

Question Comments

Question Comments

Question Comments

Question Comments

Question Comments

Videos

Groups

Evidence & References Show References

Topic Comments