Parsonage–Turner Syndrome mimicking musculoskeletal shoulder pain: A case report during the SARS-CoV-2 pandemic era

Abstract

Parsonage–Turner Syndrome or neuralgic amyotrophy is a peripheral neuropathy typically characterized by an abrupt onset of pain, followed by progressive neurological deficits (e.g. weakness, atrophy, occasionally sensory abnormalities) that involve the upper limb, mainly the shoulder, encompassing an extensive spectrum of clinical manifestations, somehow difficult to recognize. This case report describes the proper management of a 35-year-old, bank employee and sports amateur who reported subtle and progressive upper limb disorder with previous history of neck pain. SARS-CoV-2 pandemic era made patient's access to the healthcare system more complicated. Nevertheless, proper management of knowledge, relevant aspects of telerehabilitation-based consultation for musculoskeletal pain, advanced skills, tools and technologies led the physiotherapist to suspect an atypical presentation of Parsonage–Turner Syndrome. Further, neurologist consultation and electromyography suggested signs of denervation in the serratus anterior and supraspinatus muscle. Therefore, an appropriate physiotherapist's screening for referral is conducted to correct diagnosis and thorough treatment.

Letter to the Editor: Rule Out Alternative Mechanisms Before Attributing Elevated Hemidiaphragm to Parsonage Turner Syndrome and SARS-CoV-2 Vaccination

“…Needle electromyography (EMG) of muscles innervated by plexus branches is absent. Since plexitis has also been reported in connection with SARS-CoV- infection, 2 it is crucial to be informed about the result of the PCR test. We should also know the results of the virus panel and the results of cerebro-spinal fluid (CSF) tests to rule out polyradiculitis (Guillain Barre syndrome).…”