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Two Mechanisms of Scapular Winging Visualized in a Patient With Parsonage-Turner Syndrome

A 29-year-old man presented 4 months after acute onset of pain followed by bilateral shoulder weakness (video 1). He was undergoing intense police academy training at the time of onset. Left shoulder/cervical MRIs shortly after symptom onset were normal. EMG at 4 months showed widespread reinnervation changes of the proximal right upper extremity, pronounced in the serratus anterior. There were widespread reinnervation changes of the proximal left upper extremity, pronounced in the trapezius. Fourteen months after the onset of symptoms, and following intensive physical therapy, the patient showed significant improvement in bilateral shoulder function but still notable right medial scapular winging.1,2