Quality and Patient Safety Articles-Mononeuropathies in Scapular Winging

Mononeuropathies in Scapular Winging

Pdf Summary

The most likely involved nerve is <strong>B. Long thoracic nerve</strong>.

This case describes <strong>medial scapular winging</strong>: the scapula sits medially with downward rotation at rest and becomes more prominent with forward flexion. That pattern is classically caused by <strong>serratus anterior weakness</strong>, which is innervated by the <strong>long thoracic nerve</strong>.

Key points:
- <strong>Long thoracic nerve palsy</strong> → serratus anterior dysfunction → <strong>medial winging</strong>
- <strong>Spinal accessory nerve palsy</strong> → trapezius weakness → <strong>lateral winging</strong>
- A brief episode of severe shoulder pain without trauma, especially after vaccination, suggests <strong>neuralgic amyotrophy (Parsonage-Turner syndrome)</strong>, a common cause of these mononeuropathies.

So the best answer is <strong>B. Long thoracic nerve</strong>.

Keywords

long thoracic nerve

medial scapular winging

serratus anterior weakness

scapular winging

spinal accessory nerve

trapezius weakness

lateral winging

neuralgic amyotrophy

Parsonage-Turner syndrome

mononeuropathy