Asimetría escapular por agenesia congénita de trapecio unilateral: a propósito de un caso / Case report: Scapular asymmetry caused by congenital unilateral absence of trapezius

La agenesia completa unilateral de trapecio es una afección infrecuente, reportada anteriormente en la literatura tras su hallazgo en muestras cadavéricas. Afecta a la estática, biomecánica y funcionalidad de la cintura escapular, por lo que es especialmente importante realizar una exhaustiva exploración física del paciente en consulta para descartarla o sospecharla. Presentamos el caso de un niño de 8 años con asimetría de la cintura escapular y escápula alada, remitido a la consulta de Rehabilitación por sospecha de distrofia facioescapulohumeral. La RM confirmó la agenesia de músculo trapecio derecho. No había alteración de la funcionalidad en el paciente. No se encontraron otras anomalías congénitas.(AU)

Congenital unilateral absence of trapezius is a rare condition, previously reported in cadaveric specimens. It can cause static shoulder asymmetry and affects the scapular biomechanics and functionality, so complete physical examination of the patient becomes important in order to dimiss or suspect an anomaly.We present a case of a 8 years old boy with asymmetry and scapular winging, who was referred to rehabilitation, suspected facioscapulohumeral dystrophy. An MRI scan of cervical spine and shoulder confirmed the absence of the right trapezius muscle. There were no functional disabilities. No other significant congenital anomalies were found.(AU)

[Case report: Scapular asymmetry caused by congenital unilateral absence of trapezius]. / Asimetría escapular por agenesia congénita de trapecio unilateral: a propósito de un caso.

Congenital unilateral absence of trapezius is a rare condition, previously reported in cadaveric specimens. It can cause static shoulder asymmetry and affects the scapular biomechanics and functionality, so complete physical examination of the patient becomes important in order to dimiss or suspect an anomaly. We present a case of a 8 years old boy with asymmetry and scapular winging, who was referred to rehabilitation, suspected facioscapulohumeral dystrophy. An MRI scan of cervical spine and shoulder confirmed the absence of the right trapezius muscle. There were no functional disabilities. No other significant congenital anomalies were found.

Secuelas morfo-funcionales en mujeres operadas de cáncer de mama en las regiones de la Araucanía y del Bío-Bío, Chile / Morphofunctional consequences in women operated for breast cancer of the region of Araucanía and Bío-Bío, Chile

El tratamiento quirúrgico del cáncer de mama puede dejar secuelas tardías tales como escápula alada, pérdida de movilidad articular del hombro, sobrepeso, etc. Basado en lo anterior, el objetivo del presente estudio fue describir las secuelas morfofuncionales en mujeres operadas de cáncer de mama de las regiones de la Araucanía y del Bío-Bío, Chile, explorando también si el procedimiento quirúrgico conllevaría a la presencia de escápula alada. Para ello, se realizó un estudio cuantitativo, observacional y de corte transversal en treinta mujeres operadas de cáncer de mama, de edades comprendidas entre 28 y 76 años (55,67±11,60). Un profesional entrenado evaluó peso, estatura, índice de masa corporal (IMC), índice de cintura cadera (ICC), rangos articulares de hombro (ROM, Range of Movement) y fuerza prensil, aplicándose además la prueba de Hoppenfeld para identificar escápula alada. Los resultados mostraron diferencias significativas en el ROM a la abducción de hombro (p<0,05), correlación significativa positiva de leve (r=0,370) a moderada (r=0,514) entre el ROM del lado afectado tanto para la flexión como la abducción con la fuerza prensil. Destacan, un IMC de 28,91±5,31 kg/m2, un ICC de 0,86±0,06 cm y la presencia de escápula alada en el 36,7 % de las participantes. No se encontró asociación entre el abordaje quirúrgico y la presencia de escápula alada. Hubo secuelas morfo-funcionales en las mujeres en estudio, destacándose las alteraciones en el rango de movimiento del miembro superior, sobrepeso, riesgo cardiovascular y la presencia de escápula alada, sin asociarse al tipo de abordaje quirúrgico.

Surgical treatment of breast cancer can leave late sequelae such as winged scapula, loss of joint mobility of the shoulder, overweight, etc. Based on the above, the objective of the present study was to describe the morpho-functional sequelae in women operated on for breast cancer from the regions of Araucanía and Del BíoBío, Chile, also exploring whether the surgical procedure would lead to the presence of scapula winged. For this, a quantitative, observational and cross-sectional study was conducted in thirty women operated on for breast cancer, aged between 28 and 76 years (55.67 ± 11.60). A trained professional evaluated weight, height, body mass index (BMI), hip waist index (ICC), shoulder joint ranges(ROM, Range of Movement) and prehensile strength, and applied the Hoppenfeld test to identify the winged scapula. The results showed significant differences in the ROM to shoulder abduction (p <0.05), positive significant correlation of mild (r = 0.370) to moderate (r = 0.514) between the ROM of the affected side for both flexion and abduction with prehensile force. Highlights, a BMI of 28.91 ± 5.31 kg / m2, an ICC of 0.86 ± 0.06 cm and the presence of winged scapula in 36.7 % of the participants. No association was found between the surgical approach and the presence of the winged scapula. There were morphofunctional sequelae in the women under study, highlighting the alterations in the range of movement of the upper limb, overweight, cardiovascular risk and the presence of the winged scapula, without being associated with the type of surgical approach.

[Parsonage-Turner syndrome: Unknown but not infrequent. Apropos of 6 cases]. / Síndrome de Parsonage-Turner: desconocido pero no infrecuente. A propósito de 6 casos.

Shoulder pain is a common reason for seeking emergency, primary and specialist care. Parsonage-Turner syndrome should form part of the differential diagnosis of shoulder pain. Familiarity with the clinical and electrophysiological characteristics of this syndrome could help prevent iatrogenic disease. We present 6 cases of Parsonage-Turner syndrome, a syndrome of unknown etiology with a typical clinical picture. All patients had acute onset of the syndrome with intense shoulder pain of approximately 3 weeks' duration. After this phase ended, there was noticeable weakness of the affected arm, causing muscular atrophy depending on the muscles affected by the neuropathy. Winged scapula was present in all patients. One patient showed alteration of sensitivity and another showed hemidiaphragmatic paralysis. After a complete physical examination, the patients underwent electromyographic study that confirmed the diagnosis. Analgesic treatment and rehabilitation were prescribed.