Right Lobulated Paralabral Cyst extending into the spinoglenoid notch causing suprascapular nerve impingement syndrome and infraspinatous muscle atrophy.
The patient was referred to Orthopedics for arthroscopic surgery to have the labrum repaired which decompressed the suprascapular nerve at the spinoglenoid notch. Afterwards, he was enrolled in aggressive physical therapy.
Repair of labrum and resolution of shoulder pain after aggressive physical therapy. Patient was able to return to play without any pain.
I'm curious to know if this patient is right hand dominant and plays other overhead sports. Isolated infraspinatus atrophy (usually without pain) is reported in 4-34% of overhead athletes (volleyball & baseball). High Incidence of Infraspinatus Muscle Atrophy in Elite Professional Female Tennis Players.
Young SW, Dakic J, Stroia K, et al.
Am J Sports Med. 2015 Aug; 43(8):1989-93. Epub 2015 Jun 15. In addition, don't forget that nerve compression (in this case, by the cyst) is a more common cause of infraspinatus atrophy than a rotator cuff tear.
Great case & nice images.
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