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Weakness in forward elevation
3%
50/1433
Weakness in internal rotation
11%
156/1433
Weakness in external rotation
80%
1145/1433
Positive impingement maneuver
4%
55/1433
Scapular winging
1%
18/1433
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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 innervation of the supraspinatus and infraspinatus muscle, leading to weakness in both muscles. 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. Figure A and Illustration 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. Illustration B shows the anatomic locations of the suprascapular notch and the spinoglenoid notch and the course of the suprascapular nerve.
3.6
(32)
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