Teres minor innervation in the context of isolated muscle atrophy

Friend, Jikol; Francis, Sarah M.N.; McCulloch, Jane; Ecker, Jeff; Breidahl, William; McMenamin, Paul G.

doi:10.1007/s00276-009-0605-9

Cited by 34 publications

(23 citation statements)

References 11 publications

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“…This dichotomy may be due to different imaging techniques in different patient populations, or MRA may be less specific for diagnosing nQSS. Teres minor atrophy on MRI in the absence of nQSS symptoms ( Figure 1) is also nonspecific, 48,52,54,[72][73][74] and can result from variations in the length and origin of the axillary nerve 52 or from normal variant fascial slings "tenting" the course of the axillary nerve 75 (Supplemental Figure 3, available online at http://www.mayoclinic proceedings.org). Limited data exist on EMG sensitivity after vascular imaging studies suggestive of nQSS ( Figure 1) 26 because of technical difficulty with needling the teres minor.…”

Section: Discussionmentioning

confidence: 97%

Quadrilateral Space Syndrome

Brown

Doolittle

Bohanon

et al. 2015

Mayo Clinic Proceedings

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Quadrilateral space syndrome (QSS) arises from compression or mechanical injury to the axillary nerve or the posterior circumflex humeral artery (PCHA) as they pass through the quadrilateral space (QS). Quadrilateral space syndrome is an uncommon cause of paresthesia and an underdiagnosed cause of digital ischemia in overhead athletes. Quadrilateral space syndrome can present with neurogenic symptoms (pain and weakness) secondary to axillary nerve compression. In addition, repeated abduction and external rotation of the arm is felt to lead to injury of the PCHA within the QSS. This often results in PCHA thrombosis and aneurysm formation, with distal emboli. Because of relative infrequency, QSS is rarely diagnosed on evaluation of athletes with such symptoms. We report on 9 patients who presented at Mayo Clinic with QSS. Differential diagnosis, a new classification system, and the management of QSS are discussed, with a comprehensive literature review. The following search terms were used on PubMed: axillary nerve, posterior circumflex humeral artery, quadrilateral space, and quadrangular space. Articles were selected if they described patients with symptoms from axillary nerve entrapment or PCHA thrombosis, or if related screening or imaging methods were assessed. References available within the obtained articles were also pursued. There was no date or language restriction for article inclusion; 5 studies in languages besides English were reported in German, French, Spanish, Turkish, and Chinese.

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Section: Discussionmentioning

confidence: 97%

Quadrilateral Space Syndrome

Brown

Doolittle

Bohanon

et al. 2015

Mayo Clinic Proceedings

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“…From these branches the axillary nerve will innervate the teres minor, deltoid, and inferior aspect of the glenohumeral joint capsule. The exact course of the axillary nerve after exiting the quadrilateral space has proven to be quite variable [1,3,6,7,15].…”

Section: Introductionmentioning

confidence: 99%

Variations in the Innervation of the Long Head of the Triceps Brachii: A Cadaveric Investigation

Erhardt

Futterman

2017

Clinical Orthopaedics &Amp; Related Research

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Background Some leading anatomy texts state that all three heads of the triceps brachii are innervated by the radial nerve. The posterior cord of the brachial plexus bifurcates to terminate as the radial and axillary nerves. Studies have noted the presence of axillary innervation to the long head of the triceps brachii muscle, patterns different from the classic exclusive radial nerve supply. An understanding of these variations may assist the clinician in the assessment of shoulder weakness and in preoperative and operative planning of radial and axillary neuropathies. Questions/Purpose We aimed to further investigate, in cadaver dissections, the prevalence of axillary nerve contribution to the innervation of the long head of the triceps brachii. Methods We performed bilateral brachial plexus dissections on 10 embalmed cadavers combining anterior axillary and posterior subscapular approaches. Two additional unilateral cadaveric brachial plexuses were dissected. The posterior cords were fully dissected from the roots distally. The radial and axillary nerves were followed to their muscle insertion points, the dissections were photographed, and the length of branching segments were measured.

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“…Esta patología resulta de difícil diagnóstico clínico, sin embargo, no parece ser tan infrecuente y debe ser tenida en cuenta luego de descartar otras causas para poder abordar un diagnóstico temprano e indicar un tratamiento apropiado. Es importante tener en cuenta que el dolor inicial a causa de la compresión nerviosa en algunos casos suele durar un tiempo variable hasta que la atrofia del músculo afectado se completa (Friend et al, 2010), y dado que la rotación externa del hombro se preserva de todas maneras, por la acción del músculo infraespinoso, el diagnóstico puramente clínico en casos crónicos se torna más dificultoso. Siendo los deportes "sobre la cabeza" como el vóley, natación o béisbol factores que predisponen a este atrapamiento, deberían ser tenidos en cuenta durante una anamnesis detallada, más aún cuando están presentes uno o más de los tres grandes síntomas (dolor, parestesias y debilidad).…”

Section: Discussionunclassified

SÍNDROME DEL ESPACIO CUADRILÁTERO: ¿INFRECUENTE O INSOSPECHADO? Quadrilateral space syndrome: infrequent or unsuspected?

Gutierrez

Cullari

Ranaletta

et al. 2016

Rev Arg de Anat Clin

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RESUMENIntroducción: El síndrome del espacio cuadrilátero (QSS) es un cuadro clínico causado por la compresión nerviosa y/o vascular a nivel del espacio axilar lateral. La prevalencia de este síndrome se desconoce y se cree que es baja, sin embargo, formas de presentación incompleta podrían llevar a que el mismo sea subdiagnosticado. Objetivo: Describir un protocolo diagnóstico utilizado en una serie de casos consecutivos de pacientes con omalgia inespecífica y sospecha de QSS. Materiales y Métodos: De manera prospectiva se evaluaron 10 pacientes con omalgia agravada con la rotación externa forzada, uno de ellos con síntomas bilaterales. Se realizó electromiografía (EMG) de deltoides y redondo menor bilaterales, con estudios de conducción nerviosa. Los valores se compararon con el hombro sano, y con un grupo control. El diagnóstico se confirmó mediante resonancia magnética nuclear (RMN). Resultados: El EMG mostró en todos los casos atrapamiento con compromiso axonal de la rama para el redondo menor, con preservación de la inervación del deltoides. La RMN mostró en los 11 hombros afectados atrofia selectiva del redondo menor. Conclusión: El QSS en sus formas incompletas suele ser subdiagnosticado, siendo necesario mantener un alto índice de sospecha clínica frente a un cuadro de omalgia inespecífica.Palabras Claves: espacio cuadrilátero, omalgia, electromiografía, redondo menor, nervio axilar. ABSTRACTIntroduction: The quadrilateral space syndrome (QSS) has clinical features caused by a nervous and /or

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Teres minor innervation in the context of isolated muscle atrophy

Cited by 34 publications

References 11 publications

Quadrilateral Space Syndrome

Quadrilateral Space Syndrome

Variations in the Innervation of the Long Head of the Triceps Brachii: A Cadaveric Investigation

SÍNDROME DEL ESPACIO CUADRILÁTERO: ¿INFRECUENTE O INSOSPECHADO? Quadrilateral space syndrome: infrequent or unsuspected?

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