RT Journal Article
SR Electronic
T1 “Pseudo-suprascapular notch”: is it a sonographic trap in suprascapular nerve block?
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 77
OP 80
DO 10.1136/rapm-2018-000009
VO 44
IS 1
A1 Michał Podgórski
A1 Marcelina Rusinek
A1 Maciej Cichosz
A1 Łukasz Olewnik
A1 Michał Polguj
A1 Piotr Grzelak
YR 2019
UL http://rapm.bmj.com/content/44/1/77.abstract
AB 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.