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REVIEW OF NEUROPHYSIOLOGY DATA IN PATIENTS REFERRED AS WINGED SCAPULA
  1. Maruthi Ravi Vinjam,
  2. Ibrahim Ali,
  3. Taysir Bukhari
  1. Pinderfields General Hospital

    Abstract

    We conducted retrospective analysis of patients referred to the neurophysiology department as winged scapula over a period of three and half years. Data is from a medium sized district general hospital with two full time neurophysiologist who receives on average 3500 requests per year. Retrospective data was collected on patient demographics, presentation with possible etiology, neurophysiological and imaging findings.

    In total 48 patients were referred with possible diagnosis of winged scapula over this period, of which abnormal findings were noted in 41 patients.

    Findings Patient demographics: Male –66 % (n 27); female –34 % (n14), Age< 18 yrs –7.3 % (n 3), 18–40 yrs –44 % (n 18), 41–60 yrs –31.7 % (n 13), >60 yrs –17% (n 7). Shoulder pain and weakness was the presenting feature in 34% of patients (n 14), pure weakness was the presenting feature in 51% (n 21) and presentation was uncertain in the rest of the patients.

    Possible causes for winged scapula was noted as below in this patient group: Fall–6, Heavy lifting–8, Post intervention (surgery/delivery/ITU)–3, Road traffic accident–2 Post vaccination–1, Definite brachial amyotrophy/Brachial neuritis–4,Possible brachial amyotropy/Brachial neuritis –5, Muscle related–3, Not clear–9.

    Based on the neurophysiological studies both, needle EMG and Nerve conduction studies showed involvement of Long thoracic nerve in 25 patients, Spinal accessory in 5 patients, Long thoracic, spinal accessory and dorsal scapular in 2 patients, Long thoracic and axillary in 2 patients, Long thoracic with carpel tunnel (incidental with symptoms) in 4 and pure muscle related in 3 patients.

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