Season 9 Case 7

Hx: Chest Pain

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:

  • Upwardwards(blue arrows) and counter-clockwise rotation (red arrow) of the scapula so inf tip points to spine (sometimes smaller)

  • 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