POSTER SECTIONS Coverpage Learning objectives Background Findings and procedure details Conclusion Personal information References

ECR 2016 / C-1648

Scapular Dyskinesis: The role of MR Imaging.

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

C-1648

Type:

Educational Exhibit

Keywords:

Musculoskeletal system, Musculoskeletal bone, Musculoskeletal soft tissue, MR, Education, Motility

Authors:

E. Camuera¹, L. Fernandez Rodriguez², I. Hafeez ³, R. Sharma³, J. Gómez⁴, J. M. Marin⁵, J. Beltran³; ¹Bilbao/ES, ²Madrid/ES, ³Brooklyn, NY/US, ⁴León/ES, ⁵Leganés Madrid/ES

DOI:

10.1594/ecr2016/C-1648

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-1648

Fig. 1: Scapular stabilizers muscles.

Fig. 2: Scapular stabilizers muscles.

Fig. 3: Muscle attachments on the scapula. Serratus anterior muscle origin on the...

Fig. 4: Scapula movements.

Fig. 5: Scapular dyskinesis etiologies.

Fig. 6: Scapular dyskinesis is most common in baseball pitchers and swimmers. Although...

Fig. 7: Scapular dyskinesis types.

Fig. 9: Scapular stabilizing innervation.

Fig. 8: Winged scapula due to long thoracic nerve palsy. The long thoracic nerve passes...

Fig. 11: MRI of young female who practices archery. Axial T1 and STIR images show...

Fig. 12: Axial STIR image reveals high intensity of the serratus anterior muscle. This...

Fig. 10: Neurogenic causes of scapular winging.

Fig. 14: Patient with right elastofibroma dorsi located deep to serratus anterior...

Fig. 15: A-C: Right scapular winging caused by weakness of ipsilateral trapezius. Arrow...

Fig. 13: Glenohumeral pathologies graphic.

Fig. 16: Scapular dyskinesis associated pathologies.These impairments can be diagnose by...

Fig. 17: Another associated pathologies. a)Coronal oblique T2-FS MR shows a thickening...

Learning objectives

The purpose of our educational exhibit is to: Describe the term scapular dyskinesis, including the different subtypes and pathophysiology. Identify the predominant MR imaging features and associated glenohumeral joint injuries.

Background

Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. The scapula is part of the glenohumeral and acromioclavicular joint, although actually, there is not a truescapulothoracic joint. The only connection between scapula and axial skeleton is acromioclavicular joint. Stability of scapulothoracic jointdepends on surrounding musculature such as stabilizing muscles (levator scapulae, rhomboid, serratus anterior, trapezius) and shoulder rotator cuff muscles and acromiclavicular ligaments (Fig. 1-3) The purpose of the scapula is to provide a stable basis...

Findings and procedure details

There are four types of scapular dyskinesis according to Kliber classification (Fig.7): Type I - inferiormedial scapular border prominence: This typeis most commonly found in patients with rotator cuff dysfunction. Type II - medial border prominence: it is caused by weakness of stabilizing muscles Type III - superiormedial border prominence: it is often associated with impingement and rotator cuff injury. Type IV - symmetric scapulohumeral. The term SICK scapula is used to describe the pathological state of the scapula. It is characterised by: Scapula malpositionconsisting...

Conclusion

Because of the complex and wide range of motion, the glenohumeral joint is verypronetomicroinstability and soft tissue lesions in the throwing athlete. Scapular dyskinesis is a clinical diagnosis. However, conventional MR provides additional information to guide ontheetiology and collateral damages.

Personal information

References

R.M.Martin and D.E.Fish Scapular winging: anatomical review, diagnosis and treatmentsCurr Rev Musculoskelet Med. 2008 Mar; 1(1): 1–11. Ann M J Cools, F. Struyf,K.De Mey,A.Maenhout,B. Castelein, B. Cagnie Rehabilitation of scapular dyskinesis: from the officeworker to the elite overhead athleteCools AMJ, et al. Br J Sports Med 2014;48:692–697. doi:10.1136/bjsports-2013-092148 Scott Sevinsky MSPT Scapular Dykinesis W Ben Kibler,P.M Ludewig,P. W McClure,L. A Michener,K. Bak,A. D Sciascia Clinical implications of scapular dyskinesisin shoulder injury: the 2013 consensus statementfrom the ‘scapular summit’ Kibler WB, et al. Br J Sports...