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Query: UMLS:C1762617 (weakness)
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The shoulder's unique wide range of motion is largely restrained by the articular capsule and the external ligaments of the glenohumeral joint. Internally, the long head of the biceps tendon passes within the capsule and inserts on the superior lip of the glenoid labrum. Trauma distracting this tendon can tear the superior glenoid labrum, producing the superior labrum anterior to posterior (SLAP) syndrome. Four patients, two of whom were female, presented with complaints of acute shoulder pain associated with weakness in abduction and forward flexion. Routine shoulder roentgenograms were normal. Magnetic resonance imaging (MRI) studies revealed a superior glenoid labral tear consistent with a SLAP syndrome. The superior labrum, unlike the firmly bound inferior portion, is loosely attached to the glenoid fossa. This inherent mobility predisposes it to disruption. To routine ultrasonography and arthrogram, the superior labrum may be obscured by superimposed structures. Shoulder arthroscopy, computed tomography, arthrography, and MRI have relatively equal sensitivity in visualizing these labral tears. The SLAP lesion accompanies 16% of all rotator cuff tears, occurring more often than heretofore recognized. When clinically suspected, they can be readily visualized by a noninvasive MRI examination.
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PMID:Slip of the lip--tears of the superior glenoid labrum-anterior to posterior (SLAP) syndrome. A report of four cases. 853 90

We evaluated an all arthroscopic technique for treating suprascapular nerve entrapment by cyst formation in the spinoglenoid notch. Eight patients showed positive MRI and EMG findings with clinical sign of weakness and pain and with atrophy of the muscle. All patients underwent an all-arthroscopic procedure. The patients were evaluated preoperatively and 6 weeks and 3 months postoperatively and for the latest follow-up by clinical examination, MRI, and EMG. All patients improved in terms of pain, strength, and function. We found six superior labrum anterior and posterior (SLAP) lesions. In these patients the cyst was drained, and the SLAP lesion was repaired. In two patients there was no communication between the joint and the cyst, and therefore capsulotomy was performed and left open. The results of our study show that arthroscopic decompression of the suprascapular nerve can be achieved by an all arthroscopic technique if the cyst formation is located at the spinoglenoid notch.
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PMID:Compression of the suprascapular nerve by a ganglion cyst of the spinoglenoid notch: the arthroscopic solution. 1459 36

We report a case of suprascapular nerve entrapment at the suprascapular notch combined with a type II SLAP lesion resulting in supraspinatus and infraspinatus muscle weakness and shoulder pain in a 27-year-old female professional handball player. The magnetic resonance imaging scan showed significant atrophy of the supraspinatus and infraspinatus muscles. Electromyography revealed an isolated proximal lesion of the suprascapular nerve. The patient was treated by an arthroscopic release of the superior transverse ligament and repair of the type II SLAP lesion. Follow-up evaluations were performed 6 weeks, 3 months, and 6 months postoperatively. The Constant score improved from 51 to 84 points. Electromyography studies 3 and 6 months after surgery showed significant improvement with normal reinnervation of the supraspinatus and infraspinatus muscles. To our knowledge, this is the first report of proximal suprascapular nerve entrapment with coincidence of a SLAP lesion that was treated arthroscopically. On the basis of this case, we found that arthroscopic release of the superior transverse ligament is an effective procedure for decompression of the suprascapular nerve. Although it is a technically demanding procedure, the arthroscopic approach has the advantage of detecting concomitant lesions such as SLAP lesions.
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PMID:Arthroscopic release of the superior transverse ligament and SLAP refixation in a case of suprascapular nerve entrapment. 1791 87

Suprascapular nerve entrapment is a common condition in athletes. The entrapment is most frequently due to a "glenoid labral cyst" produced by joint fluid extrusion in consequence of labral degenerative changes. The bilaterality of the entrapment and the association with rotator cuff pathology are a rare evidence. We present the case of a 38-year-old amateur weightlifter with an history of left shoulder chronic posterior pain and progressive external rotation weakness, and with an acute right shoulder pain and weakness. Magnetic resonance imaging showed a bilateral glenoid labral cyst in association with partial tear of the supraspinatus tendon, atrophy of the infraspinatus muscle and type 2 SLAP lesion at the left shoulder and subacromial impingement syndrome (due to acromio-clavicular osteophyte), mild atrophy of the infraspinatus muscle and type 1-2 SLAP lesion at the right side.
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PMID:Bilateral suprascapular nerve entrapment by glenoid labral cysts associated with rotator cuff damage and posterior instability in an amateur weightlifter. 2030 74

A SLAP lesion can be found with a concomitant spinoglenoid notch cyst. The cyst can cause suprascapular nerve compression, resulting in shoulder pain and weakness of external rotation. Their management varies from conservative treatment to operative treatment. Cyst decompression through the labral tear is our preferred treatment. Previous studies demonstrated a good result after arthroscopic decompression of the cyst through the labral tear combined with SLAP repair. Many surgeons usually use 3 portals to perform this procedure. However, we prefer to use only 2 portals, 1 anterior viewing portal and 1 posterior working portal. This strategy is more time and cost efficient. The patient is positioned in lateral decubitus. The SLAP lesion is demonstrated by using a probe. Tissue elevator is inserted into the labral lesion to penetrate into the cyst wall. A soft anchor is placed. A birdbeak suture passer penetrates the posterior labrum. Then knot tying is done. The advantages of this single working portal technique are short operative time, a decreased risk of iatrogenic rotator cuff injury from accessory anterolateral portal or posterior labral injury from posterolateral portal, and avoiding unnecessary superior capsule incision for cyst exposure.
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PMID:Arthroscopic Decompression of Spinoglenoid Notch Cyst and SLAP Repair Through a Single Working Portal. 3025 79