Monday, December 16, 2013

Case review 10: Droopy shoulder syndrome

Anteroposterior (AP) Shoulder  x-ray
Right Lateral Shoulder x-ray

History
 
This lady presented with numbness of the little and ring fingers on both sides.
On physical examination, she appears to have rather long neck and low shoulders. 
This is consistent with Droopy Shoulder Syndrome causing Thoracic Outlet Syndrome.


X-ray findings

Radiologically, the cervical spine is morphologically normal but T2 vertebra is visible above the
shoulders on lateral cervical spine films. 

Discussion


In Droopy Shoulder Syndrome, the shoulders are low-set and the neck is described as long swan
neck. The patients are mostly female and presents with pain or numbness in the neck, shoulder,
arms and hands. The pain can be aggravated by downward traction and relief by propping up the
arms.

Thoracic outlet syndrome is a rare condition that involves pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone. Similar presentation may occur with other causes of thoracic outlet syndrome such as cervical rib.
 

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