Chest Wall: Scapula


Chest Wall: Scapula

Table 5.16 Scapula: hypoplasia




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.


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).

Fig. 5.17a, b Brachial plexus palsy in an 8-year-old. Although the humeral head appears relatively normal, the glenoid is hypoplastic (a) and sloped posteriorly (arrow in b).
Fig. 5.18 Recurrent shoulder dislocations. Osseous Bankart lesion from recurrent shoulder dislocation (arrow) and accompanying intraarticular body in the posterior joint.
Fig. 5.19a–c Sprengel deformity. Klippel-Feil syndrome with small left ribs (a) and a hypoplastic and superiorly located left scapula (Sprengel deformity) that articulates with the neck (b, c).

Table 5.17 Scapula: expansion and destruction





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).

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Jul 12, 2020 | Posted by in PEDIATRIC IMAGING | Comments Off on Chest Wall: Scapula

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