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“Pseudo-suprascapular notch”: is it a sonographic trap in suprascapular nerve block?
  1. Michał Podgórski1,
  2. Marcelina Rusinek2,
  3. Maciej Cichosz2,
  4. Łukasz Olewnik3,
  5. Michał Polguj2 and
  6. Piotr Grzelak1
  1. 1 Radiology Department, Polish Mother Memorial Hospital Research Institute, Lodz, Poland
  2. 2 Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
  3. 3 Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
  1. Correspondence to Michał Podgórski, Radiology Department, Polish Mother Memorial Hospital Research Institute, Łódź 93-338, Poland; michal.podgorski{at}


Background and objectives The aim of the study was to describe the radiological anatomy of the pseudo-suprascapular notch—a structure localized at the floor of the supraspinatus fossa, just below the true suprascapular notch. In sonographic examination, it may imitate the suprascapular notch leading to misidentification of these structures.

Methods Ultrasound assessment of the suprascapular notch region was performed in 100 patients who underwent chest CT due to other indications. The presence of the suprascapular notch and the pseudo-suprascapular notch was evaluated together with their maximal width and depth using both techniques. The correlation between the dimensions of these two notches was assessed.

Results The pseudo-suprascapular notch was recognized in 82 patients. In four of them the suprascapular notch could not be visualized in ultrasound due to obscuring clavicle. In all cases the pseudo-suprascapular notch contained a small artery. In comparison to the suprascapular notch, the pseudo-suprascapular notch was significantly narrower and shallower, except for 10 cases with vestigial suprascapular notch where the pseudo-suprascapular notch was the only hollow in this region. The dimensions of both structures did not correlate with each other. Finally, the pseudo-suprascapular notch did not present any significant asymmetry (p=0.1185) or sexual dimorphism (43 women vs 38 men, p=0.2025).

Conclusions The pseudo-suprascapular notch is a hollow for nutrient vessels that can be mistaken for the regular suprascapular notch in cases of difficult sonographic navigation.

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  • Presented at Preliminary report from this work was presented at the European Congress of Radiology in Vienna, Austria, March 1–5, 2017.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed