Neuromuscular ultrasound for evaluation of scapular winging

Krzesniak‐Swinarska, Monika; Caress, James B.; Cartwright, Michael S.

doi:10.1002/mus.25533

Cited by 15 publications

(4 citation statements)

References 27 publications

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“…The upper trapezius is innervated by both the SAN and motor branches from the C2, C3, and C4 roots of the cervical plexus . During electrodiagnostic testing, the currents from standard bipolar stimulation of the SAN inevitably spread to motor branches from the cervical plexus.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound in the management of iatrogenic spinal accessory nerve palsy at the posterior cervical triangle area

Shen

Chen

et al. 2018

Muscle and Nerve

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Ultrasound provides direct images about nerve lesions contributing to the diagnosis of iatrogenic spinal accessory nerve palsy at the posterior cervical triangle area and also reveals lesion location, assisting in formulating suitable surgical plans preoperatively. We recommend that ultrasound be integrated into the preoperative evaluation. This article is protected by copyright. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Ultrasound in the management of iatrogenic spinal accessory nerve palsy at the posterior cervical triangle area

Shen

Chen

et al. 2018

Muscle and Nerve

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“…Ultrasound can help determine the optimal muscle biopsy site; the use of tissue Doppler evaluation before and after the biopsy can also help minimize potential complications by avoiding vessels and nerves 54 . Furthermore, ultrasound can be used to guide needle EMG to distinguish muscles in close proximity, 55 and to enhance patient safety when needling the diaphragm, 56 the periscapular muscles, 57 or other muscles in patients on anticoagulants 58 . In a cadaveric study, ultrasound greatly improved needle EMG placement accuracy in most muscles 59 .…”

Section: Practical Uses Of Muscle Ultrasoundmentioning

confidence: 99%

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Mah

Alfen

2018

Can. J. Neurol. Sci.

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Advances in high-resolution ultrasound have provided clinicians with unique opportunities to study diseases of the peripheral nervous system. Ultrasound complements the clinical and electrophysiology exam by showing the degree of abnormalities in myopathies, as well as spontaneous muscle activities in motor neuron diseases and other disorders. In experienced hands, ultrasound is more sensitive than MRI in detecting peripheral nerve pathologies. It can also guide needle placement for electromyography exam, therapeutic injections, and muscle biopsy. Ultrasound enhances the ability to detect carpal tunnel syndrome and other focal nerve entrapment, as well as pathological nerve enlargements in genetic and acquired neuropathies. Furthermore, ultrasound can potentially be used as a biomarker for muscular dystrophy and spinal muscular atrophy. The combination of electromyography and ultrasound can increase the diagnostic certainty of amyotrophic lateral sclerosis, aid in the localization of brachial plexus or peripheral nerve trauma and allow for surveillance of nerve tumor progression in neurofibromatosis. Potential limitations of ultrasound include an inability to image deeper structures, with lower sensitivities in detecting neuromuscular diseases in young children and those with mitochondrial myopathies, due to subtle changes or early phase of the disease. As well, its utility in detecting critical illness neuromyopathy remains unclear. This review will focus on the clinical applications of neuromuscular ultrasound. The diagnostic values of ultrasound for screening of myopathies, neuropathies, and motor neuron diseases will be presented.

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“…Second, we have taken only subsequent photographs in most patients, while videos would have enabled a more accurate assessment of scapular dyskinesis. Our preferred next research step would, therefore, be a comparative trial on the effect of targeted physical therapy on scapular dyskinesis in both DM1 and FSHD patients, including quantitative clinical assessment and imaging (MRI or muscle ultrasound) before and after treatment [22, 23]. Furthermore, such study will allow estimating the prevalence of this condition.…”

Section: Discussionmentioning

confidence: 99%

Scapular dyskinesis in myotonic dystrophy type 1: clinical characteristics and genetic investigations

Voermans¹,

Bilt²,

IJspeert³

et al. 2019

J Neurol

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ObjectiveTo study scapular winging or other forms of scapular dyskinesis (condition of alteration of the normal position and motion of the scapula) in myotonic dystrophy type 1 (DM1), which is generally considered to be a distal myopathy, we performed an observational cohort study.MethodsWe performed a prospective cohort study on the clinical features and progression over time of 33 patients with DM1 and pronounced, mostly asymmetric scapular winging or other forms of scapular dyskinesis. We also explored if scapular dyskinesis in DM1 has the same genetic background as in facioscapulohumeral muscular dystrophy type 1 (FSHD1).ResultsThe cohort included patients with congenital (n = 3), infantile (n = 6) and adult-onset DM1 (n = 24). Scapular girdle examination showed moderate shoulder girdle weakness (mean MRC 3) and atrophy of trapezius, infraspinatus, and rhomboid major, seemingly similar as in FSHD1. Shoulder abduction and forward flexion were limited (50–70°). In five patients, scapular dyskinesis was the initial disease symptom; in the others it appeared 1–24 years after disease onset. Follow-up data were available in 29 patients (mean 8 years) and showed mild to severe increase of scapular dyskinesis over time. In only three patients, DM1 coexisted with a FSHD mutation. In all other patients, FSHD was genetically excluded. DM2 was genetically excluded in nine patients. The clinical features of the patients with both DM1 and FSHD1 mutations were similar to those with DM1 only.ConclusionScapular dyskinesis can be considered to be part of DM1 in a small proportion of patients. In spite of the clinical overlap, FSHD can explain scapular dyskinesis only in a small minority. This study is expected to improve the recognition of shoulder girdle involvement in DM1, which will contribute to the management of these patients.Electronic supplementary materialThe online version of this article (10.1007/s00415-019-09494-8) contains supplementary material, which is available to authorized users.

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Neuromuscular ultrasound for evaluation of scapular winging

Abstract: Ultrasound is a non-invasive, painless, and radiation-free technology that can be used to evaluate scapular winging. Muscle Nerve 56: 7-14, 2017.

Cited by 15 publications

References 27 publications

Ultrasound in the management of iatrogenic spinal accessory nerve palsy at the posterior cervical triangle area

Ultrasound in the management of iatrogenic spinal accessory nerve palsy at the posterior cervical triangle area

Neuromuscular Ultrasound: Clinical Applications and Diagnostic Values

Scapular dyskinesis in myotonic dystrophy type 1: clinical characteristics and genetic investigations

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