Erb palsy

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

History of birth trauma and subsequent left shoulder mal-alignment.

ct

Drooping of the left shoulder girdle which appears atrophic (compared to the right side):

  • asymmetrical reduced/atrophic muscle volume of the left shoulder girdle compared to the right side

  • the following osseous changes (glenohumeral dysplasia) include:

    • the humeral head appears small showing fragmentation and irregularity of its epiphysis. It shows posterior subluxation

    • signs of mild to moderate glenoid dysplasia evident by truncation of the posterior bony glenoid and indistinct margins

    • elongated coracoid process is noted

Drooping of the left shoulder girdle which appears atrophic (compared to the right side):

  • asymmetrical reduced/atrophic muscle volume of the left shoulder girdle compared to the right side

  • the following osseous changes (glenohumeral dysplasia) include:

    • the humeral head appears small showing fragmentation and irregularity of its epiphysis. It shows posterior subluxation

    • signs of mild to moderate glenoid dysplasia evident by truncation of the posterior bony glenoid and indistinct margins

    • elongated coracoid process is noted

Case Discussion

The case demonstrates the chronic denervation sequel of Erb's palsy with left shoulder girdle muscular, osseous and soft tissue atrophic changes.

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