PMC3173831_01
A 7-year-old girl showing Sprengel deformity on the right shoulder (a, b, c) The right scapula is raised, shorter, and larger than the contralateral one. There is no restriction in the right shoulder movements.
JCIS-1-13-g002.jpg
PMC3173831_01_JCIS-1-13-g002.jpg
F1
The right scapula was small and elevated on physical examination but there was no impaired movement of the shoulder [Figure 1].
(a) Plain radiograph shows increased horizontal/vertical length of the right scapula. There is no omovertebral bony connection. (b) Coronal and (c) axial magnetic resonance (MR) images of the right scapula.
JCIS-1-13-g003.jpg
PMC3173831_01_JCIS-1-13-g003.jpg
F2
There was increased horizontal to vertical length of the scapula and no omovertebral bony connection was observed in the plain radiographs [Figure 2a]. MRI showed a thin hypointense band extending from the superomedial angle of the scapula to the 7th cervical vertebra's spinous process [Figures 2b, c, and 3].
Sagittal MR image series (a, b, c, d) demonstrate the omovertebral band. (c) Omovertebral band and peripheral fat tissue both look like an eye. *Points to the superomedial angle of the right.
JCIS-1-13-g004.jpg
PMC3173831_01_JCIS-1-13-g004.jpg
F3
MRI showed a thin hypointense band extending from the superomedial angle of the scapula to the 7th cervical vertebra's spinous process [Figures 2b, c, and 3]. In this patient, we observed a new MRI sign that we have named as "Ra's eye" to define the appearance of omovertebral band within the surrounding fat tissue [Figure 3c].
PMC3173831_02
A 9-year-old boy showing Sprengel deformity on the right side. Right scapula is raised and neck appears plump and shorter on the same side.
JCIS-1-13-g006.jpg
PMC3173831_02_JCIS-1-13-g006.jpg
F4
The right scapula was found to be raised and fixed medially on physical examination [Figures 4].
(a) Axial and (b) coronal MR images of the right scapula show a thick and short hypointense OB extending from the superomedial angle of the scapula to the 7th cervical vertebra's spinous process.
JCIS-1-13-g007.jpg
PMC3173831_02_JCIS-1-13-g007.jpg
F5
In the MRI, there was a thick and short hypointense band seen between the superomedial angle of the scapula and the posterior components of the 7th  cervical vertebra [Figure 5].
Ultrasound image of the omovertebral band. Arrowheads point to the fibrous component and * points the cartilaginous component. S: Scapula.
JCIS-1-13-g008.jpg
PMC3173831_02_JCIS-1-13-g008.jpg
F6
The omovertebral band was confirmed with ultrasonography (US) [Figure 6].
Photograph of the omovertebral band as seen during the surgical (modified "Green") procedure.
JCIS-1-13-g009.jpg
PMC3173831_02_JCIS-1-13-g009.jpg
F7
The patient underwent surgery and the fibrous omovertebral band was resected [Figure 7].