Ultrasound imaging for an uncommon cause of shoulder pain: Metastatic brachial plexopathy in a woman with breast cancer
Journal
Journal of Medical Ultrasound
Journal Volume
27
Journal Issue
3
Pages
160-161
Date Issued
2019
Author(s)
Abstract
A 42-year-old female had a history of breast cancer. She complained of the left shoulder pain for the past 6 months. She was treated as a frozen shoulder initially in a rehabilitation clinic due to progressively limited shoulder range of motion. Since physical therapy was not helpful, she was referred for a shoulder ultrasound (US) examination. The prescanning physical examination showed only 50% of normal shoulder motion range in all directions and weakness in the shoulder abduction, elbow flexion, and the hand grasping strength. There were no symptoms such as Horner syndrome or paresthesia at her upper extremity. As there was no remarkable US finding of rotator cuffs, the transducer was relocated more proximally to investigate the supraclavicular region. The brachial plexus appeared diffusely swollen in contrast to that at the contralateral side [Figure The enlarged nerve bundles could be visualized all the way back to the root level. Brachial plexopathy due to cancer metastasis was impressed and later confirmed by the magnetic resonance imaging (MRI). She did not receive a biopsy of the brachial plexus lesion. Subsequent radiochemotherapy was arranged, and she had a significant recovery of shoulder movement and strength 3 months later with concurrent physical therapy (range of motion exercise and shoulder girdle muscle-strengthening). The subsequent US images showed decreased sizes of the previous swollen nerve roots.
SDGs
Other Subjects
adult; breast cancer; case report; clinical article; echography; female; frozen shoulder; grip strength; human; Letter; metastatic brachial plexopathy; muscle training; nuclear magnetic resonance imaging; peripheral neuropathy; physiotherapy; range of motion; shoulder girdle; shoulder pain
Publisher
Wolters Kluwer Medknow Publications
Type
letter