53-year-old male:
– Persistent right shoulder pain, no movement limitations.
– No previous trauma.
– Shoulder MRI is performed
What do you see?
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Quadrangular/Quadrilateral space syndrome
– Posteroinferior paralabral cyst (arrow) extending into the quadrangular space
– Teres minor mild fatty infiltration – atrophy (circle)
– Neurovascular compression syndrome of the posterior humeral circumflex artery (PHCA) and/or the axillary nerve or one of its major branches in the quadrangular space
– Multiple causes of compression: fibrotic bands, ganglion/cysts, aneurysms, tumours
– MRI may demonstrate atrophy and/or denervation edema of the teres minor and/or deltoid muscles
– Differential diagnosis: Parsonage-Turner sd, disuse atrophy