25 yr old male, Pain ,weakness -7 months insiduous onset
No history of injury. Conservative treatment for 6 months elsewhere
external rotation weakness (rt) shoulder, Wasting of infraspinatus
MRI Confirms an spinoglenoid ganglion. Options include open excision, ultrasound guided aspiration, arthroscopy to adddress labral lesion and ganglion. We Elected to do an arthroscopic ganglion decompression with immediate relief of pain. Surprisingly no labral tears were found and the ganglion alone was decompressed.
We has since then done another similar case where in a large type 2 b labral tear which was repaired.
Infra spinatus wasting
Options of management include
Spontaneous resolution of the ganglion piatt et al j.of shoulder and elbow surgery,2002 (2 pts )
IMAGE GUIDED ASPIRATION OF THE CYSTS (mixed results)
recurrence common , Tung et al j.of roentgenology 2000 ¾ recurrence in 4 months
Open excision deltoid splitting/detachment
intraarticular pathology undiagnosed
Arthroscopic
Snyder et al ,j.of arthroscopy,2006
Iannotti et al,j.of arthroscopy 1996
chen et al j. of arthroscopy,2003
Never heard that one before--where exactly is it located---------Mohan Thadi, AIMS, Kochi
ReplyDeleteitis further down the course from the suprascapular notch as the nerve wind round the spine of scapula
ReplyDeleteHow did you reach the notch using scope?
ReplyDeleteCamera-posterior portal and working A-L/ Lateral portal? What angle scope is it?
Is the suprascapular notch reached through the sub-acromial bursa or the joint?
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