John Hunter's MSK Teaching File
Interesting MRI Cases from University of Washington Department of Radiology

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Case 31 Discussion

Tear of the teres minor muscle with partial tear/contusion of the anterior deltoid muscle. The study showed no evidence of posterior deltoid atrophy or mass in the quadrilateral space, features of the quadrilateral space syndrome. We presume that the weakness was secondary to acute muscle injury with possible transient injury to the axillary nerve contributing to weakness. The neurologic symptoms subsided within a few days of injury.

The quadrilateral space is bounded medially by the long head of the triceps muscle, laterally by the humerus, superiorly by the teres minor and inferiorly by the teres major (see below). The axillary nerve and posterior humeral circumflex artery traverse this space. Nerve entrapment by mass, fibrous bands, or fracture fragments may be seen; possibly, contusion of the nerve during the injury sustained by the patient contributed to the clinical picture.

above image from Primal 3D Interactive Series (www.primalpictures.com)

Shoulder MRI Cases

Case 32