Season 9 Case 7
Hx: Chest Pain
Answer: Sprengel's Deformity
-M/C congenital abnl of the shoulder
-Failure of Downward migration of scapula (starts mid-cervical)
-often part of Klippel-Feil Deformity (cervical vertebral fusion)
-shoulder asymmetry w decreased ABduction
Sprengel's Imaging:
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Upwardwards(blue arrows) and counter-clockwise rotation (red arrow) of the scapula so inf tip points to spine (sometimes smaller)
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Uni- or Bi- lateral
-Look for bony omovertebral bone (bony or fibrous scapulo-vertebral connection - usually C4-C7) - up to 50%
-Look for rib/spine abnl (green arrows) (Klippel -Feil)
Sprengel's Clinical
-Graded upon degree of elevation
-cosmetic and/or decreased shoulder mobility yields shoulder muscular hypoplasia/atrophy
-trt: physical therapy versus surgery
