{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:21:56Z","timestamp":1788337316415,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Objectives: Peripheral nerve injuries around the shoulder are increasingly recognized in athletes who perform repetitive overhead motions. Suprascapular neuropathy is well described in volleyball players, whereas axillary neuropathy is usually attributed to dislocation or direct trauma. Concurrent, painless, non-traumatic involvement of both nerves is rare and may be mistaken for disuse or a rotator cuff disorder. Case Presentation: A 17-year-old male national-level volleyball player presented with painless atrophy of the dominant shoulder, noticed three months earlier, without trauma, dislocation, instability or pain. Examination showed infraspinatus fossa wasting and predominantly anterior deltoid atrophy, Medical Research Council grade 4 strength in external rotation, forward elevation and abduction, intact lateral deltoid sensation, symmetrical reflexes and a negative Spurling test. Radiographs were unremarkable. Magnetic resonance imaging showed fatty degeneration and atrophy of the infraspinatus and anterior deltoid with relative preservation of the supraspinatus, and no rotator cuff tear, labral tear, paralabral cyst or space-occupying lesion. Motor nerve conduction studies showed a reduced compound muscle action potential recorded from the infraspinatus with a preserved response from the supraspinatus after suprascapular nerve stimulation, together with a reduced deltoid response after axillary nerve stimulation. Selective involvement of the infraspinatus branch was most consistent with a suprascapular lesion at or distal to the branch to the supraspinatus, clinically compatible with involvement around the spinoglenoid notch, and argued against a C5 root or upper trunk lesion. Conclusions: Painless shoulder atrophy in an overhead athlete warrants systematic evaluation for peripheral nerve injury. The pattern of motor responses can localize the lesion, but in the absence of needle electromyography a multifocal process such as neuralgic amyotrophy (Parsonage\u2013Turner syndrome) cannot be excluded, and a sport-related traction or compression mechanism should therefore be advanced cautiously.<\/jats:p>","DOI":"10.3390\/diagnostics16172820","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:53:11Z","timestamp":1788335591000},"page":"2820","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Painless Concurrent Suprascapular and Axillary Neuropathy in a Young Elite Volleyball Player: A Case Report"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3644-6701","authenticated-orcid":false,"given":"Jaesung","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Dankook University Hospital, 201 MangHyang-ro, Dongnam-gu, Cheonan 31116, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Wook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dankook University Hospital, 201 MangHyang-ro, Dongnam-gu, Cheonan 31116, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1177\/0363546504264582","article-title":"Nerve injury about the shoulder in athletes, part 1: Suprascapular nerve and axillary nerve","volume":"32","author":"Safran","year":"2004","journal-title":"Am. J. Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1002\/pmrj.12762","article-title":"A review of upper extremity peripheral nerve injuries in throwing athletes","volume":"14","author":"Bowers","year":"2022","journal-title":"PM&R"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4085\/1062-6050-0476.22","article-title":"Knee, low back, and shoulder problems among university and professional volleyball players: Playing with pain","volume":"59","author":"Skazalski","year":"2024","journal-title":"J. Athl. Train."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/1941738118756577","article-title":"Risk factors for shoulder injuries in female athletes playing overhead sports: A systematic review","volume":"10","author":"Keller","year":"2018","journal-title":"Sports Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1136\/bjsm.34.3.174","article-title":"Suprascapular neuropathy in volleyball players","volume":"34","author":"Witvrouw","year":"2000","journal-title":"Br. J. Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/bjsm.28.3.177","article-title":"Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players","volume":"28","author":"Holzgraefe","year":"1994","journal-title":"Br. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1080\/00913847.2020.1766344","article-title":"Did the prevalence of suprascapular neuropathy in professional volleyball players decrease with the changes occurred in serving technique?","volume":"49","author":"Mazza","year":"2021","journal-title":"Phys. Sportsmed."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1302\/0301-620X.81B4.0810679","article-title":"The incidence of nerve injury in anterior dislocation of the shoulder and its influence on functional recovery: A prospective clinical and EMG study","volume":"81","author":"Visser","year":"1999","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1177\/1941738119868478","article-title":"Isolated axillary nerve injury in an elite high school American football player: A case report","volume":"11","author":"Probst","year":"2019","journal-title":"Sports Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/2011.8.FOCUS11183","article-title":"Axillary nerve injury associated with sports","volume":"31","author":"Lee","year":"2011","journal-title":"Neurosurg. Focus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1007\/s00264-025-06465-9","article-title":"Dark side of the shoulder: Suprascapular and axillary nerve compressions","volume":"49","author":"Ayik","year":"2025","journal-title":"Int. Orthop."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1590\/S0004-282X1993000100020","article-title":"Isolated and painless infraspinatus atrophy in top-level volleyball players: Report of two cases and review of the literature","volume":"51","author":"Tengan","year":"1993","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1136\/jnnp.60.3.345","article-title":"Axillary neuropathy in volleyball players: Report of two cases and literature review","volume":"60","author":"Paladini","year":"1996","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_14","first-page":"347","article-title":"Silent deltoid atrophy in beach volleyball players: A report of two cases and literature review","volume":"10","author":"Monteleone","year":"2015","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/mus.26630","article-title":"Suprascapular neuropathy: A review of 87 cases","volume":"60","author":"Memon","year":"2019","journal-title":"Muscle Nerve"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"617","DOI":"10.5435\/JAAOS-D-19-00526","article-title":"The evaluation and management of suprascapular neuropathy","volume":"28","author":"Strauss","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bozzi, F., Alabau-Rodriguez, S., Barrera-Ochoa, S., Ateschrang, A., Schreiner, A.J., Monllau Garc\u00eda, J.C., and Perelli, S. (2020). Suprascapular neuropathy around the shoulder: A current concept review. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082331"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/neuros\/nyy050","article-title":"\u201cIsolated\u201d suprascapular neuropathy: Compression, traction, or inflammation?","volume":"84","author":"Maldonado","year":"2019","journal-title":"Neurosurgery"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Hangge, P.T., Breen, I., Albadawi, H., Knuttinen, M.G., Naidu, S.G., and Oklu, R. (2018). Quadrilateral space syndrome: Diagnosis and clinical management. J. Clin. Med., 7.","DOI":"10.3390\/jcm7040086"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jor.2020.01.021","article-title":"Teres minor and quadrilateral space syndrome: A review","volume":"20","author":"Dalagiannis","year":"2020","journal-title":"J. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1136\/jnnp-2020-323164","article-title":"Neuralgic amyotrophy: A paradigm shift in diagnosis and treatment","volume":"91","author":"Gstoettner","year":"2020","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/mus.28274","article-title":"Neuralgic amyotrophy: An update in evaluation, diagnosis, and treatment approaches","volume":"71","author":"Gabet","year":"2025","journal-title":"Muscle Nerve"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1002\/mus.25008","article-title":"Neuralgic amyotrophy: An update on diagnosis, pathophysiology, and treatment","volume":"53","author":"Groothuis","year":"2016","journal-title":"Muscle Nerve"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1136\/jnnp-2022-330296","article-title":"Effectiveness of an outpatient rehabilitation programme in patients with neuralgic amyotrophy and scapular dyskinesia: A randomised controlled trial","volume":"94","author":"Janssen","year":"2023","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/mus.27705","article-title":"A standardized ultrasound approach in neuralgic amyotrophy","volume":"67","author":"Cignetti","year":"2023","journal-title":"Muscle Nerve"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e625","DOI":"10.5114\/pjr.2019.92422","article-title":"Ultrasound elastography as a potential method to evaluate entrapment neuropathies in elite athletes: A mini-review","volume":"84","author":"Zakrzewski","year":"2019","journal-title":"Pol. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00264-025-06417-3","article-title":"Diagnostic ultrasonography of upper extremity dynamic compressive neuropathies in athletes: A narrative review","volume":"49","author":"Nguyen","year":"2025","journal-title":"Int. Orthop."},{"key":"ref_28","first-page":"899","article-title":"Imaging on the painful and compressed nerve: Upper extremity","volume":"49","author":"Bordalo","year":"2025","journal-title":"Int. Orthop."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/17\/2820\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:02:41Z","timestamp":1788336161000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/17\/2820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":28,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diagnostics16172820"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16172820","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}