Quadrilateral space syndrome: a review

Area of Science:

• Orthopedics
• Sports Medicine
• Anatomy

Background:

• Quadrilateral space syndrome (QSS) is a rare condition involving neurovascular compression within the quadrilateral space.
• It typically presents as shoulder pain and paresthesia, often aggravated by specific arm movements.

Purpose of the Study:

• To summarize the clinical presentation, diagnostic challenges, and treatment strategies for Quadrilateral space syndrome.
• To highlight the effectiveness of surgical decompression for refractory QSS.

Main Methods:

• Review of existing literature on Quadrilateral space syndrome.
• Analysis of diagnostic indicators including physical examination and lidocaine blocks.
• Evaluation of nonoperative and operative treatment outcomes.

Main Results:

• QSS is characterized by shoulder pain and paresthesia, with diagnosis often challenging.
• Lidocaine block of the axillary nerve can aid diagnosis.
• Nonoperative management is recommended initially, with surgery showing good results for persistent symptoms.

Conclusions:

• Quadrilateral space syndrome requires a high index of suspicion for diagnosis.
• While nonoperative treatments are the first line, surgical decompression is an effective option for symptom resolution and return to activity.