Paralabral Cyst

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Paralabral Cyst

Authors, Editors, Case Information Author: Cameron Taylor, DO Affiliation: Inspira Physical Medicine & Rehabilitation Residency/Rowan-Virtua School of Osteopathic Medicine Co Author(s): Tamzid Hassan, DO; Altamash Raja, DO, RMSK, CSCS Senior Editor: Nick Moore, MD Clinical Vignette: A 27-year-old swimmer presented with right anterolateral shoulder pain, weakness, numbness, burning, and paresthesias radiating down the anterior upper arm and medial forearm into the fourth and fifth digits. Pain was exacerbated by shoulder extension and abduction with difficulty engaging periscapular muscles while swimming. On exam, atrophy of the infraspinatus was noted. Type of Probe Used: 15-4 MHz Linear Transducer LXA Unlabeled Paralabral Cyst with Doppler Long axis view of paralabral cyst at the spinoglenoid notch with doppler. LXA Labeled Paralabral Cyst with SSN Long axis view of paralabral cyst at spinoglenoid notch with labels. Note the honeycombing structure that is the suprascapular nerve (SSN) SAX Labeled Paralabral Cyst Short axis view with labels of paralabral cyst at the spinoglenoid notch with measurements of the cyst showing depth of 3.23cm. SXA Unlabeled Paralabral Cyst Short axis view of paralabral cyst at the spinoglenoid notch with measurements showing depth of 3.23cm LXA Unlabeled Paralabral Cyst Measured Long axis view of paralabral cyst at the spinoglenoid notch with measurements showing width of 1.18cm and height of 1.64cm. LXA Labeled Paralabral Cyst Long axis view with labels of paralabral cyst () at the spinoglenoid notch. LXA Unlabeled Paralabral Cyst Long axis view of paralabral cyst at the spinoglenoid notch Interpretation Image Interpretation:* A well-circumscribed, anechoic mass, measuring 1.18 cm x1.64 cm x 3.23 cm is appreciated within the spinoglenoid notch. The mass is noncompressible and without internal Doppler flow. By sliding the transducer slightly more proximal, the suprascapular nerve is visualized and appears grossly enlarged, however, still has preservation of the characteristic honeycomb appearance. These findings are suggestive of a paralabral cyst causing suprascapular neuropathy. Teaching Pearl: Paralabral cysts are a common finding associated with glenoid labral tears. Although they are usually found in the spinoglenoid notch (adjacent to the glenohumeral joint), the cystic fluid can migrate and accumulate in the suprascapular notch as well. The location of the cyst is critical in determining the accompanying dysfunction. Considering the course of the suprascapular nerve, which branches off the brachial plexus and passes through the suprascapular notch and then the spinoglenoid notch, a spinoglenoid notch cyst will impinge upon the nerve and affect the infraspinatus muscle only, whereas a cyst in the suprascapular notch will affect both the supraspinatus and infraspinatus muscles. Clinically, this can manifest as weakness, atrophy, edema, and fatty infiltration with prolonged impingement. An ultrasound-guided cyst aspiration can be helpful in symptomatic management, however, cysts can recur. Therefore, addressing the labral pathology, which is the underlying cause may be necessary.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

LXA Unlabeled Paralabral Cyst with Doppler

LXA Labeled Paralabral Cyst with SSN

SAX Labeled Paralabral Cyst

SXA Unlabeled Paralabral Cyst

LXA Unlabeled Paralabral Cyst Measured

LXA Labeled Paralabral Cyst

LXA Unlabeled Paralabral Cyst

Interpretation

UPCOMING EVENTS

FIND A SPORTS DOC

Authors, Editors, Case Information

LXA Unlabeled Paralabral Cyst with Doppler​

LXA Labeled Paralabral Cyst with SSN​

SAX Labeled Paralabral Cyst​

SXA Unlabeled Paralabral Cyst​

LXA Unlabeled Paralabral Cyst Measured

LXA Labeled Paralabral Cyst​

LXA Unlabeled Paralabral Cyst​

Interpretation

UPCOMING EVENTS

FIND A SPORTS DOC

LXA Unlabeled Paralabral Cyst with Doppler

LXA Labeled Paralabral Cyst with SSN

SAX Labeled Paralabral Cyst

SXA Unlabeled Paralabral Cyst

LXA Labeled Paralabral Cyst

LXA Unlabeled Paralabral Cyst