Weekly Case

Title : case 229

Age / Sex : 66 / M




Age / Sex : M/66





Chief complaint : Rt. Shoulder pain (1MA)






1) What is your impression?



Two weeks later, you can see the final diagnosis with a brief discussion of
this case.



* Send Application Answers to In Sook Lee, MD (lis@pusan.ac.kr)



Courtesy : Kim Su Jin, SMG -
SNU Boramae Medical Center




Diagnosis:

Parsonage-Turner syndrome



Discussion




Findings: Rt.
Brachial plexus swelling and
Rt. supraspinatus and
infraspinatus muscle, swelling and enhancement,



 



Differential Diagnosis: suprascapular nerve entrapment



 



Diagnosis:
 Parsonage-Turner syndrome



 



Discussion:



 



Parsonage-Turner syndrome = acute idiopathic brachial
neuritis



1>   Sx. : sudden
onset of shoulder pain or weakness of the shoulder girdle musculature



2>   prevalence :
1.64/100000 people

             male> female

             unilateral > bilateral
(1/3)



3>   cause: viral
and autoimmune process are suggested.



4>   Dx.: MR and
EMG



:EMG: acute denervation in the
brachial plexus distribution

 MR finding:

       - brachial plexus swelling

       - denervation of shoulder girdle
and chest wall including supraspinatus and infraspinatus muscles (most common),
deltoid, teres minor, subscapularis, latissimus dorsi, pectoralis



 



 



References: MRI Findings of 26 Patients with Parsonage-Turner Syndrome AJR 2007;
189:W39-W44





Correct Answer
Name Institution
total applicants 20
correct answer 12
윤민아 서울대학교병원
정선혜 (전공의) 순천향 부천병원
김민지 서울의료원
김현주 순천향대학교부속 서울병원
이승훈 한양대병원
박희진 강북삼성병원
조신영 웰튼병원
정진영 삼성서울병원
최희석 부평세림병원
김건우 (전공의) 강동경희대학교병원
김성윤 동대문튼튼병원
박소현 (전공의) 경희의료원
semi-correct answer 8
최성규 스마일영상의학과
유성혜 (전공의) 고대안암병원
손범석 (전공의) 세브란스병원
지숙경 삼성서울병원
홍새롬 (전공의) 세브란스병원
김승수 (전공의) 순천향 천안병원
안경식 고대안암병원
정유미 가천의대 길병원

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