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Review Question - QID 519

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QID 519 (Type "519" in App Search)
An MRI of the shoulder in a patient with chronic quadrilateral space syndrome is most likely to show which of the following?

Increased intra-capsular volume

2%

39/2257

Loss of intra-capsular volume

2%

37/2257

Fatty atrophy of the infraspinatus

4%

82/2257

Fatty atrophy of the teres minor

90%

2042/2257

Fatty atrophy of the latissimus dorsi

2%

47/2257

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Quadrilateral space syndrome involves dysfunction of the axillary nerve, perhaps by entrapment or compression, resulting in the functional denervation of the teres minor.

The quadrilateral space is a potential space formed by the long head of the triceps medially, the humerus laterally, the teres minor above, and the teres major below. The axillary nerve and posterior circumflex humeral artery travel through this space.

The Sanders article describes the MRI appearance, which is that the muscle appears streaked with white on MRI and atrophied (See illustration A) consistent with fatty atrophy. Sanders group report this finding in 3% of shoulder MRIs. The posterior circumflex humeral artery also travels with the axillary nerve as it travels through this space. Loss of capsular volume on an arthrogram study is suggestive of adhesive capsulitis.

Illustration B is a diagram which shows the borders of the quadrilateral (or quadrangular) space.

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