IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Parsonage turner syndrome

Case contributed by Abeer Ahmed Alhelali
Diagnosis almost certain

Presentation

50-year-old male patient presented with a history of gradually increasing left shoulder pain for the last 1 year radiating to left upper extremity and restricting the range of movement. No history of trauma.

Patient Data

Age: 50-year-old
Gender: Male
mri

MRI left shoulder without contrast shows hyperintense signal in multiple muscles predominantly involving supraspinatus, infraspinatus and part of the deltoid muscles on T2 fat sat images. No mass lesion compressing the axillary or suprascapular nerve.No atrophy or fatty infiltration.

Case Discussion

Parsonage-Turner syndrome is an acute idiopathic brachial neuritis. It is twice as common in men than women 1.

Almost all cases involve the suprascapular nerve with nearly 50% of the cases solely affecting it. One-third of the case are bilateral 2.

The etiology of Parsonage-Turner syndrome is unclear; however, few predisposing factors are suggested such as minor trauma, surgery, gunshot wounds and infections 3,4.

On MRI shoulder, muscles initially look normal, but over the next few weeks, muscular denervation changes appear as high T2 signal, as in the current case. Later on, atrophy and fatty infiltration well develop with reduced muscle bulk and increased T1 signal.

The condition usually responds to conservative treatment 2.

Case submitted by Dr Abeer Ahmed Alhelali and Dr Mohamed Ashfaque Kukkady.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.