Korean J Sports Med.  2023 Dec;41(4):201-206. 10.5763/kjsm.2023.41.4.201.

Can Suprascapular Venous Engorgement with a Paralabral Cyst in the Shoulder Aid the Diagnosis of Suprascapular Neuropathy?: A Cohort Study of Level of Evidence III

• Lee J
• Park JY
• Park HK
• Kim Ts

• KMID: 2548993
• DOI: http://doi.org/10.5763/kjsm.2023.41.4.201

Abstract

Purpose
Suprascapular neuropathy can be caused by a solid mass, transverse scapular ligament hypertrophy, paralabral cyst, or dilatation of a suprascapular vein. Studies have measured the size of the cyst and veins using magnetic resonance imaging (MRI) to aid diagnosis of suprascapular neuropathy. However, it is often difficult to determine the size of a cyst and vein. we measured cyst and vein size as potential diagnostic markers for suprascapular neuropathy.
Methods
This study retrospectively enrolled 118 patients diagnosed with a paralabral cyst in a clinic from January 2016 to December 2019. After excluding other neuropathies and cysts not related to the course of the suprascapular nerve, a total of 67 patients were analyzed. The cyst diameter, cyst volume, and vein diameter were measured engorgement by MRI in axial, coronal, and sagittal T2-weighted images. Cutoff values were established based on Youden’s index.
Results
There was no significant difference between the neuropathy and control groups in cyst coronal diameter, but the neuropathy group had greater sagittal (p=0.001), axial (p=0.001), and maximum cyst diameters (p=0.005), cyst volume (p=0.003), and coronal (p=0.002), axial (p=0.001), and maximum vein diameters (p=0.001).
Conclusion
In suprascapular neuropathy symptomatic patients, electromyography/nerve conduction velocity tests are eventually needed when in doubt. However, measuring cyst diameter, volume, and suprascapular vein diameter as a screening test could be considered.

Keyword

Paralabral cyst; Cyst diameter; Suprascapular neuropathy; Suprascapular vein

Figure

• 

  Fig. 1 Diameter of a paralabral cyst (bidirectional arrows) on magnetic resonance images in the left shoulder of a 23-year-old man. (A) Coronal oblique view, 17.1 mm. (B) Sagittal oblique view, 24.4 mm. (C) Axial view, 8.7 mm.

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  Fig. 2 Diameter of suprascapular veins (bidirectional arrows) on magnetic resonance images in the right shoulder of a 16-year-old man. (A) Axial view, 3.8 mm. (B) Coronal oblique view, 4.5 mm.

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  Fig. 3 (A) Receiver operating characteristic (ROC) curves of cyst coronal diameter, cyst sagittal diameter, cyst axial diameter, cyst volume, and cyst max diameter. (B) ROC curves of suprascapular vein max diameter, suprascapular vein coronal diameter, and suprascapular vein axial diameter.

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