yogabook / pathology / scapula alata

Definition

Mostly unilateral, rarely also bilateral medial flare-up (clear distance margo medialis scapulae to the thorax) of the shoulder blade of various aetiologies. In addition to disorders of the innervation of the muscles fixing the shoulder blade (serratus anterior, rhomboids, trapezius), muscle diseases are also a possible cause. The scapula alata is most pronounced in disorders of the rhomboids.

Ursache

1. Disruption of the innervation of the relevant muscles
2. Neuralgic shoulder amyotrophy
3. Limb girdle dystrophies
4. Fascioscapulohumeral muscular dystrophy
5. Oto-fasciocervical syndrome
6. Duchenne progressive muscular dystrophy

Prädisponierend

Diagnose

1. Inspection
2. X-ray to rule out bony changes
3. If necessary, MRI to examine the nerves, tendons and muscles for lesions
4. OP in cases of trauma
5. EMG

Symptome

1. Medially protruding scapula, i.e. significant distance between margo medialis scapulae and thorax
2. in the case of innervation disorder of the serratus anterior: increase in distance during frontal abduction or forward pressure against a solid object. This is the most common form.
3. In case of innervation disorder of the trapezius: lateralisation of the scapula withpositive distance of the margo medialis. No increase in the distance, especially with lateral abduction, but not with frontal abduction.
4. In case of innervation disorder of the rhomboids and levator scapulae: lateralisation of the scapula. Increase in distance especially with lateral abduction, but not with frontal abduction.

Komplikationen

Therapie

1. If possible, causal therapy of the cause
2. Orthosis
3. PT
4. Nerve or tendon grafts