Suprascapular neuropathy in a shoulder referral practice

Area of Science:

• Orthopedic Surgery
• Neurology
• Diagnostic Imaging

Background:

• Suprascapular neuropathy (SSN) is a rare condition with unclear diagnostic criteria.
• Clinical presentation of SSN can be challenging due to overlapping shoulder pathologies.

Purpose of the Study:

• To characterize SSN in an academic shoulder referral practice.
• To identify electrodiagnostic findings used in SSN diagnosis.
• To test the hypothesis that SSN is frequently diagnosed in patients with suggestive clinical and radiographic findings.

Main Methods:

• Retrospective review of 1-year patient data.
• Inclusion of patients who completed electrodiagnostic studies for suprascapular nerve evaluation.
• Documentation of clinical exam findings, associated shoulder pathology, and analysis of electromyography (EMG) and nerve conduction studies (NCS).

Main Results:

• 42% of 92 patients with electrodiagnostic studies had confirmed SSN.
• Massive rotator cuff tears were associated with higher likelihood of abnormal SSN studies (P = .006).
• Common abnormalities included abnormal motor unit action potentials (88%); denervation was present in 33%.

Conclusions:

• SSN was diagnosed in 4.3% of new patients and 43% of those with clinical/radiographic suspicion.
• Electrophysiologic evaluation is crucial for confirming SSN, especially when symptoms overlap with other shoulder conditions.
• Shoulder surgeons should utilize specific electrodiagnostic parameters for accurate SSN diagnosis.