Occlusion of the posterior humeral circumflex artery: detection with MR angiography in healthy volunteers and in a patient with quadrilateral space syndrome.

Sonographic evaluation of the axillary artery during simulated overhead throwing arm positions

“…Consistent with the findings of Mochizuki et al (1994) and Rohrer et al (1990), the present study's data reinforces the risk of false positive outcomes with shoulder manoeuvres at the extreme of range. Uniquely, however, the present study's data extends this risk to include diagnostic tests performed at 1201 abduction.…”

“…It is, therefore, important for clinicians to be aware that vessel occlusion has been demonstrated not only in symptomatic but in asymptomatic subjects as well. For example, Mochizuki et al (1994) reported posterior humeral circumflex artery occlusion in the hyperabducted position in 80% of asymptomatic subjects using magnetic resonance angiography. Rohrer et al (1990) reported axillary artery compression in 83% of the 92 arms tested (baseball pitchers, athletes and non-athletes) but results were limited by incomplete blood flow assessments and poorly defined testing positions and subject groups.…”

Ultrasound findings of teres minor denervation in suspected quadrilateral space syndrome

“…The finding of occlusion in the stress position has until now been described in the radiology literature only in association with MR angiography. 4,7,8 It is not specific, because the same signs may be found in asymptomatic volunteers. 8 Nevertheless, its presence preoperatively and its absence postoperatively might be useful, because some authors emphasize that decompression of the quadrilateral space is effective if the pulse of the PHCA remains palpable when the arm is abducted and rotated externally during the operation.…”

“…4,7,8 It is not specific, because the same signs may be found in asymptomatic volunteers. 8 Nevertheless, its presence preoperatively and its absence postoperatively might be useful, because some authors emphasize that decompression of the quadrilateral space is effective if the pulse of the PHCA remains palpable when the arm is abducted and rotated externally during the operation. 1,19,20 The value of a reduced flow in the PHCA during stress maneuver is not entirely clear, and the potential usefulness of sonography needs to be evaluated in future studies.…”

“…Initially this study was performed in the position described above, and was then repeated with the arm raised to the head with hyperabduction and external rotation. 7,8 In the first arm position, flow signals in the PHCA were seen near its origin, whereas in the maximum stress position no flow signal was identified (Figure 2). Examination of the opposite healthy side revealed flow signals in both stress positions.…”