A 50 year old male presents with sudden onset of severe right scapular / shoulder pain of 4 days duration. He denies cervical neck pain, no history of trauma, no recent surgeries. No fever/chills and no bad habits. On exam you note full ROM of the upper extremity, grip strength is normal however he is unable to extend his wrist and first digit. No additional deficits. What diagnosis should you consider?

 

Parsonage-Turner Syndrome is an idiopathic brachial plexopathy which usually consists of sudden onset of severe shoulder/scapular pain with a delayed neuropathy. Usually it is self limited but can be severely debilitating, with sensory deficits or atrophy lasting many weeks. One should always be vigilant for emergent causes of neuropathy and back pain, but you’ll look good with neurology if you pull this one out when applicable.

Hand. 2007 December; 2(4): 218–221.
Published online 2007 July 4. doi:  10.1007/s11552-007-9059-x