{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T04:05:54Z","timestamp":1747109154809,"version":"3.40.5"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Periscapular pain and dysfunction are relatively common complaints in the practice of upper extremity surgeons. However, evaluation of the dysfunctional scapula is intimidating for most. Physical examination of the periscapular muscles is very rich, and a systematic approach provides the opportunity to establish a diagnosis for most patients. Conditions underlying scapular dysfunction include trapezius palsy, serratus palsy, brachial plexus injuries, muscular dystrophy, snapping scapula, pectoralis minor syndrome, congenital undescended scapula, and functional scapular dyskinesis, among others. Patients should be examined with their torso uncovered and assessed from the front and back. Inspection, evaluation of motion, and strength testing may be followed by certain examination maneuvers specific for each condition. The scapular assistance test may help predict the outcome of treatment for certain conditions. Plain radiographs oftentimes need to be complemented with magnetic resonance of the chest to capture periscapular muscles as well as an electromyogram with nerve conduction studies. Computed tomography is particularly helpful for skeletal abnormalities. Ultrasound is used to assess certain peripheral nerve injuries and to guide diagnostic and therapeutic injections. A focused evaluation of the scapula followed by a more specific and directed approach for each condition suspected will allow upper extremity surgeons to approach the evaluation of the dysfunctional scapula with much more confidence.<\/jats:p>","DOI":"10.1097\/bth.0000000000000484","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T08:00:51Z","timestamp":1724054451000},"page":"182-191","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Dysfunctional Scapula"],"prefix":"10.1097","volume":"28","author":[{"given":"Joaquin","family":"Sanchez-Sotelo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,9]]},"reference":[{"key":"R1-20250512","first-page":"587","article-title":"The scapula: the greater masquerader of shoulder pathologies","volume":"73","author":"Wagner","year":"2024","journal-title":"Instr Course Lect"},{"key":"R3-20250512","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jhsa.2015.06.123","article-title":"Scapular and shoulder girdle muscular anatomy: its role in periscapular tendon transfers","volume":"41","author":"Crowe","year":"2016","journal-title":"J Hand Surg Am"},{"key":"R4-20250512","first-page":"609","article-title":"Scapular dyskinesia: how to differentiate between etiologies","volume":"73","author":"Wagner","year":"2024","journal-title":"Instr Course Lect"},{"key":"R5-20250512","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s11552-014-9659-1","article-title":"Pseudo-winging of the scapula caused by scapular osteochondroma: review of literature and case report","volume":"10","author":"Flugstad","year":"2015","journal-title":"Hand (N Y)"},{"key":"R6-20250512","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1097\/01.ta.0000174718.83440.75","article-title":"Clinical signs of accessory nerve palsy","volume":"60","author":"Chan","year":"2006","journal-title":"J Trauma"},{"key":"R7-20250512","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/00003086-199911000-00004","article-title":"Long thoracic nerve injury","volume":"368","author":"Wiater","year":"1999","journal-title":"Clin Orthop Relat Res"},{"key":"R8-20250512","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s40634-022-00491-x","article-title":"Arthroscopic release of the pectoralis minor tendon from the coracoid for pectoralis minor syndrome","volume":"9","author":"Haeni","year":"2022","journal-title":"J Exp Orthop"},{"key":"R9-20250512","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/00003086-199911000-00003","article-title":"Spinal accessory nerve injury","volume":"368","author":"Wiater","year":"1999","journal-title":"Clin Orthop Relat Res"},{"key":"R10-20250512","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1177\/0363546514526373","article-title":"Scapulothoracic bursitis and snapping scapula syndrome: a critical review of current evidence","volume":"43","author":"Warth","year":"2015","journal-title":"Am J Sports Med"},{"key":"R11-20250512","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5435\/JAAOS-20-06-364","article-title":"Scapular dyskinesis and its relation to shoulder injury","volume":"20","author":"Kibler","year":"2012","journal-title":"J Am Acad Orthop Surg"},{"key":"R12-20250512","doi-asserted-by":"crossref","first-page":"518","DOI":"10.3171\/2014.12.SPINE14968","article-title":"Surgical outcomes of 156 spinal accessory nerve injuries caused by lymph node biopsy procedures","volume":"23","author":"Park","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"R14-20250512","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jse.2009.02.015","article-title":"The active elevation lag sign and the triangle sign: new clinical signs of trapezius palsy","volume":"18","author":"Levy","year":"2009","journal-title":"J Shoulder Elbow Surg"},{"key":"R15-20250512","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/j.hansur.2020.09.016","article-title":"Scapula alata: Diagnosis and treatment by nerve surgery and tendon transfers","volume":"41s","author":"Lafosse","year":"2022","journal-title":"Hand Surg Rehabil"},{"key":"R16-20250512","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.jseint.2022.05.002","article-title":"Serratus anterior dysfunction examination: wall push-up or shoulder flexion resistance test?","volume":"6","author":"Lohre","year":"2022","journal-title":"JSES Int"},{"key":"R17-20250512","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jns.2015.02.026","article-title":"Is pushing the wall, the best known method for scapular winging, really the best? 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