boy with elevated scapula

look at this boy his mother c o rt scapula look more elevated than lt scapula h o rta injury to rt scapular region all movementa are very normal..... this is normal varient or need further evaluation



Winged scapula..Or Scapula alata.. Muscles of the scapula are too weak or paralyzed, resulting in a limited ability to stabilize the scapula. As a result, the medial border of the scapula protrudes, like wings.... The most common cause of scapular winging is paralysis of the serratus anterior muscle due to the injury of the long thoracic nerve. Dorsal scapular neuropathy may result in abnormal motion of the shoulder joint with scapular winging. The most common surgical treatments for scapular winging are nerve and muscle transfers.

This particular abnormality of called as 'winging of scapula' It is seen in case of damage to long thoracic nerve, that is nerve to serratus anterior, causing paralysis of serratus anterior muscle Nerve conduction study will confirm the diagnosis

Look like Klippel feil syndrome Undescended scapula Supra numerary ribs in thoracic area Supero medial corner of scapula connected to base of skull by a bridge Xray will confirm Undescended scapula need surgical correction

Winged scapula paralysis of serratus Ant.msuscle scapulothoracal muscle training: Push-up with a plus (additional protraction of the scapula) Elevation in the scapular flat in exorotation Elbow push-up Press-up Low rowing Horizontal abduction Retroflexion against resistance Serratus punch upright, prone and fitter Dynamic hug Elbow in the back pocket’-exercise  If not progress then surgical treatment


Winged Scapula,

Looks like medial winging of scapula due to prominence of medial border of scapula Serratus anterior muscle weakness May be due to long thoracic nerve injury Look for any fractures of inferior angle of scapula Advise electromyography Advise scapular bracing Nsaids ,Physiotherapy Avoid carrying weights over shoulder Can observe for nerve injury to recover If movements and patient activity is normal just need observation. .

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