Scapula prominence

Introduction A person with a thin body has a shoulder blade that looks very unattractive. The so-called scapula wing-like protrusion refers to the shoulder blade behind the sides. Due to the relationship between muscle stability or nerve damage, it can be seen in a natural state, or the arm can do certain movements to see a prominent situation. Generally, the scapula wing-shaped protrusion can be divided into one side and two sides. According to the common protruding direction, it can be divided into the inward protruding (protruding in the direction of the back sacral vertebra) or protruding outward.

Cause

The muscles in the upper part of the back are weak, including bad postures such as chest hunchback, and diseases such as spinal pain.

an examination

Related inspection

Bone and joint MRI examination of bone and joint soft tissue CT examination posture and gait

Generally, the scapula wing-shaped protrusion can be divided into one side and two sides. According to the common protruding direction, it can be divided into the inward protruding (protruding in the direction of the back sacral vertebra) or protruding outward.

The scapula is fixed by a total of seven muscles on the thoracic cavity, namely the trapezius muscle, the levator scapula, the rhomboid, the small rhomboid, the large pectoral muscle, the scapular clavicle muscle and the anterior serratus. These muscle groups are responsible for the stability of the scapula, also known as the scapula stabilization muscle. Since a large part of the stability of the arm movement comes from the scapula, the lesions of the stable muscle group can significantly affect the movement of the shoulder joint and the movement of the arm.

Bilateral scapular wing projections are usually associated with hunchbacks, while asymmetrical bilateral projections are often associated with atlas lateral curvature.

The medial protuberance is often caused by the weakness of the anterior serratus (which is dominated by the long thoracic nerve). When the patient's arm is pushed to the wall or tries to raise the arm, the lower edge of the scapula will be raised and the shoulder blade will be painful. Shoulder joint mobility is limited (especially during abduction and internal rotation), and subsequent inflammatory response of the shoulder rotator and tendon. The fifth and sixth cervical radiculopathy, brachial plexus injury, upper shoulder humeral nerve compression, atlas vertebral curvature, rotational muscle injury, trapezius muscle paralysis, or humeral fracture healing, and chondroma, sometimes A situation similar to this symptom.

The lateral protrusion is due to the trapezius muscle (the eleventh pair of cranial nerves). When the shoulder is adducted, it will be found that one side protrudes to the outside, and when the shoulder movement is performed, there is a situation of unilateral weakness or shoulder height asymmetry. Because the scapula protrudes due to muscle spasm, it usually combines the chronic traction of nearby muscles to cause pain, so the pain near the protrusion is often mistaken for refractory.

For the diagnosis of this disease, the detailed physical examination and medical history inquiry of the specialist are required, and the exact lesion can be found by using the electromyography and nerve conduction in the electrical diagnosis. In terms of treatment, in addition to the use of muscle electrical stimulation to strengthen the muscles, you can also do the appropriate scapular stabilization muscles to strengthen the movement to avoid injury to the shoulder joint. It is worth noting that some muscle neurogenic diseases are also manifested by the scapula wing.

Differential diagnosis

Scapular dysplasia and abnormal shape: Sprengel malformation refers to the scapula is higher than the normal part of the thorax, usually accompanied by dysplasia and abnormal shape. Other congenital malformations may also occur, such as cervical ribs, rib dysplasia, and cervical deformity (Klippel-Feil syndrome), with occasional or partial absence of one or more scapular muscles.

Unless the deformity is severe, there is generally no serious dysfunction. When the deformity is light, only the scapula is slightly elevated, and the scapula is slightly smaller than normal and mildly restricted. However, in severe cases, the scapula is not only small, but also has a high position and even reaches the occipital bone. The patient's head is tilted to the affected side. About 1/3 of the patients have an extra small bone, the shoulder vertebrae, which is a diamond-shaped bone or cartilage block, located in a solid fascia sheath and extending from the upper scapula to one or more Spinous processes, lamina, and transverse processes of the lower cervical spine. Sometimes the shoulder vertebrae and the scapula form well-developed joints; sometimes only fibrous tissue is connected to the scapula; it is extremely rare to form a bridge in the shoulder and shoulder blades. Cho applied 3D CT to perform morphometric study on 15 patients and found that the morphological features of the high scapula were mainly reduced in the ratio of the scapula height to width, but larger than the contralateral scapula; the rotation function of the scapula and the scapula The high position is inversely related, and there is no significant difference between the shape of the joint and the joint.

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