Chest Wall: Scapula

10.1055/b-0034-87922

**Table 5.16 Scapula: hypoplasia**
Diagnosis	Findings	Comments
Brachial plexus palsy (Erb palsy) Fig. 5.17a, b	Variable degrees of hypoplasia of the inferior glenoid with posterior subluxation of the humeral head.	Severity may be placed into various categories with cross-sectional imaging.
Recurrent shoulder dislocations Fig. 5.18	Osseous Bankart and Hill-Sachs lesions.	Recurrent impaction and wear on the anteroinferior glenoid (most commonly) by the humeral head.
Osteonecrosis	Subchondral collapse leads to joint destruction.	DD: sickle cell disease, steroids, radiation and chemotherapy treatments, pancreatitis, etc.
Sprengel deformity Fig. 5.19a–c, p. 506	Small elevated and rotated scapula ± omocervical (or omovertebral) bone that joins scapula to C5 or C6.	Most common congenital anomaly of the shoulder girdle. Complex anomaly that is associated with malposition and dysplasia of the scapula, regional muscle hypoplasia/atrophy. Associated with Klippel-Feil syndrome.
Dysplasias and syndromes		Achondroplasia, hypochondroplasia, achondrogenesis, campomelic dysplasia, cleidocranial dysplasia, Alpert syndrome.
Glenoid hypoplasia	Hypoplasia of the scapular neck, widened glenohumeral joint space. Bilateral.	± Hypoplasia of other regional structures (humeral head, acromion, clavicle).

**Table 5.17 Scapula: expansion and destruction**
Diagnosis	Findings	Comments
Osteomyelitis	Permeative or moth-eaten pattern of bone destruction.	DD: round blue cell tumors.
Tumors or metastases	Permeative or moth-eaten pattern of bone destruction.	DD: osteosarcoma (new bone formation) and Ewing sarcoma.
Infantile cortical hyperostosis (Caffey disease)	(see Table 5.11 )
Langerhans cell histiocytosis	Lytic lesion or expansile hyperplastic lesion.	May be indistinguishable from osteomyelitis and tumors (round blue cell).