Alex Girden

The Problem Scapular winging is a rare condition that results in abnormal scapular motion, causing pain and decreased functionality of the upper extremity. The diagnosis can be missed, leading to unnecessary surgery, although a thorough physical examination and proper diagnostic studies can lead to the correct diagnosis as well as elucidating the underlying etiology. Causes…

The Problem Facioscapulohumeral muscular dystrophy (FSH) is an autosomal dominant condition with frequent sporadic cases that is the third most common dystrophy. First described in 1884, it has a prevalence estimated at 1:20,000. Although it has a wide-ranging clinical spectrum, there is a high penetrance, so greater than 95% of patients will have clinical symptoms…

The Problem Palsy of the eleventh cranial nerve, the spinal accessory nerve (SAN), is a rare cause of scapular winging, leading to a painful disability about the upper extremity. There are often subtle differences that allow it to be differentiated from other etiologies of scapular winging, although at times clinical examination alone cannot detect the…