High Resolution Ultrasound of Scapulae Alatae - a Prospective Case Control Study

Study Overview
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Brief Summary
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Scapula alata, caused by disturbance in the scapulothoracic stabilizer muscles due to nerve injury, is a relatively rare but also underreported disease. It can lead to years of invalidity of the affected upper extremity, considerable pain and social and emotional consequences for the patients. Unrecognized and misdiagnosed scapula alata and, consequently, wrong or delayed treatment is a general problem in this patient group. Today the diagnosis is based on the clinical examination and the electrophysiological examination. One of the problems is that the electrophysiological examination in a fair part of the patients is not showing any pathology even though the history of the patient and the clinical evaluation are indicating scapula alata. This study is a single-blinded, prospective, controlled multicentre study. The aim of the study is to investigate whether ultrasound can be used as a supplement to the electrophysiological examination when diagnosing scapula alata. Ultrasound will be used to visualize possible thickening of the cross-sectional area of nerves and the degree and pattern of muscle involvement in patients with scapula alata. By comparing measurements from scapula alata patients with the measurements from healthy controls, we are able to see if ultrasound can distinguish these two groups from each other. Furthermore, we will examine whether the ultrasound measurements correlate with the electrophysiological findings in patients and, when available, compare the ultrasound measurements of muscle thickness with MRI (magnetic resonance Imaging) findings. The use of ultrasound in scapula alata patients may help determine the presence and severity of a nerve lesion and the subsequent degree of muscle involvement and may therefore serve as a supplement to the clinical diagnosis.

Official Title
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High Resolution Ultrasound of Scapulae Alatae - Correlation With Electrophysiological Measurements - a Prospective Case Control Study

Conditions
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Scapula Alata, Scapular Winging

Intervention / Treatment
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* Diagnostic Test: High resolution ultrasound


Participation Criteria
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Eligibility Criteria
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Patients: Inclusion Criteria: Clinical suspicion of scapula alata Exclusion Criteria: Winged scapula due to other cause than nerve damage. eg. myopathy Healthy subjects Exclusion Criteria: History of Shoulder trauma or shoulder disease History of cervical radiculopathy History of upper extremity peripheral neuropathy/plexopathy Peripheral vascular disease

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>High resolution ultrasound | Diagnostic Test: High resolution ultrasound<br>* Using a high-frequency linear array transducer (18L6 HD)<br>* Other names: Siemens ACUSON S1000;|
| Healthy subjects<br>High resolution ultrasound | Diagnostic Test: High resolution ultrasound<br>* Using a high-frequency linear array transducer (18L6 HD)<br>* Other names: Siemens ACUSON S1000;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thickness of musculus serratus anterior |  | 10-15 minuttes | 
| Thickness of musculus trapezius |  | 10-15 minuttes | 
| Thickness of musculus rhomboideus |  | 10-15 minuttes | 
| Cross sectional area of nervus thoracicus longus |  | 10-15 minuttes | 
| Cross sectional area of nervus accesorius |  | 10-15 minuttes | 
| Cross sectional area of nervus dorsalis scapularis |  | 10-15 minuttes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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scapula/innervation*, Thoracic Nerves/injuries*, Peripheral Nerve Injuries, Shoulder, Musculoskeletal Diseases/diagnosis*