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Diagnosing Suprascapular Neuropathy in Patients With Shoulder Dysfunction: A Report of 5 Cases

MK Walsworth, PT, MPT, ECS, OCS, is Staff Physical Therapist, Walter Reed Army Medical Center, Washington, DC
JT Mills III, PT, MS, ECS, OCS, is Chief, Physical Therapy Service, McDonald Army Community Hospital, Ft Eustis, Va
LA Michener, PT, PhD, ATC, SCS, is Assistant Professor, Department of Physical Therapy, Room 100, West Hospital Basement, Virginia Commonwealth University–Medical College of Virginia Campus, Richmond, VA 23298 (USA) (lamichen{at}vcu.edu).

Address all correspondence to Dr Michener

Background and Purpose. Suprascapular neuropathy, resulting in shoulder pain and weakness, is frequently misdiagnosed. The consequences of misdiagnosis can include inappropriate physical rehabilitation or surgical procedures. The purpose of this case report is to describe the differential diagnosis of suprascapular neuropathy. Case Descriptions. Five patients were initially diagnosed with subacromial impingement syndrome and referred for physical therapy. Physical therapist examination findings were consistent with subacromial impingement syndrome and suprascapular neuropathy. Subsequent electrophysiologic testing confirmed the diagnosis of suprascapular neuropathy in all 5 patients. Discussion. The differential diagnosis of patients with suprascapular neuropathy includes subacromial impingement syndrome, rotator cuff pathology, C5–6 radiculopathy, and upper trunk brachial plexopathy. The diagnostic process and a table with key findings based on evidence and clinical experience is presented for differential diagnosis.

Key Words: Electrodiagnosis • Electromyography • Nerve • Shoulder • Suprascapular neuropathy