PMC9634466_01
Right-sided winged scapula resulting from impairment of the long thoracic nerve.
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At his 8-week post-operative follow-up visit, he was found to have right scapula winging (Figure 1).
Serratus anterior comparing the asymptomatic side (red arrow) to the symptomatic side (yellow arrow) short axis over the mid axillary line. Note the increased echogenicity consistent with denervation atrophy of the symptomatic side.
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There was evidence of prominent denervation atrophy affecting the right serratus anterior, consistent with a chronic long thoracic nerve palsy (Figure 2).
Proximal right forearm, ulnar side, short axis. Note the increased echogenicity of the FCU, FDP ULN and the FDP MED muscle supplied by the median nerve. The increased echogenicity denotes prominent denervation atrophy. FCU, flexor carpi ulnaris; FDP ULN, flexor digitorum profundus-ulnar; FDP MED, flexor digitorum profundus-median.
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Muscles innervated by the ulnar and median nerve showed signs of denervation atrophy (Figure 3).
Axilla, short axis (left is lateral). The ulnar nerve (yellow arrow) lies medial to the AA. The nerve is enlarged with prominent fascicles in the lower part of the nerve. Compare the size of the ulnar nerve to the median nerve (red arrow). AA, axillary artery.
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The ulnar nerve was normal in the forearm, at the elbow and upper arm, but unequivocally enlarged at the axilla (Figure 4).