Summary about Disease
Undescended scapula, also known as Sprengel's deformity, is a rare congenital condition where one or both scapulae (shoulder blades) fail to descend completely during fetal development. This results in a scapula that sits higher on the back than normal, often causing cosmetic deformity and limited shoulder movement. It can occur in isolation or be associated with other skeletal or organ system abnormalities.
Symptoms
Elevated scapula on one or both sides
Limited range of motion in the affected shoulder(s)
Asymmetry of the shoulders
Prominent bump or bony prominence on the upper back (often caused by the omovertebral bone/cartilage)
Neck webbing (skin folds)
Scoliosis (curvature of the spine) may develop
Muscle weakness in the affected shoulder and arm
Cosmetic concerns due to shoulder asymmetry
Causes
Sprengel's deformity is a congenital condition, meaning it is present at birth. The exact cause is not fully understood, but it is thought to be related to:
Failure of the scapula to descend properly during fetal development (usually occurs between the third and ninth weeks of gestation)
Association with an omovertebral bone or cartilage (a connection between the scapula and the cervical spine) which hinders the descent.
Genetic factors might play a role, but the specific genes involved are not well-defined.
Often sporadic, without a clear family history.
Medicine Used
There is no specific medicine to cure undescended scapula. Treatment focuses on managing symptoms and improving function.
Pain relievers: Over-the-counter or prescription pain medications (e.g., NSAIDs) can help manage pain and discomfort.
Muscle relaxants: May be used to alleviate muscle spasms.
Botulinum toxin (Botox): In some cases, Botox injections may be used to relax tight muscles around the shoulder and improve range of motion, but this is not a standard treatment.
Is Communicable
No. Undescended scapula is not a communicable or contagious disease. It is a congenital condition.
Precautions
There are no specific precautions to prevent undescended scapula as it is a congenital condition.
Early diagnosis and management can help optimize outcomes.
Physical therapy exercises should be performed carefully to avoid overstraining the shoulder.
Protective gear should be worn during sports to minimize risk of injury.
How long does an outbreak last?
Undescended scapula is not an infectious disease and does not involve outbreaks. It is a condition present from birth that is permanent unless surgically corrected.
How is it diagnosed?
Physical Examination: A doctor will assess the position of the scapula, range of motion, and any associated deformities.
X-rays: These imaging studies can confirm the diagnosis and show the elevated position of the scapula, as well as the presence of an omovertebral bone.
CT Scan or MRI: These imaging studies may be used to evaluate the condition of the muscles and soft tissues around the shoulder and to assess for any other associated abnormalities.
Timeline of Symptoms
Symptoms are present at birth and usually noticed in infancy or early childhood. The severity of symptoms can vary depending on the degree of scapular elevation and associated conditions. The condition does not have a specific "timeline" of progression after diagnosis; it remains constant unless surgical intervention is undertaken.
Important Considerations
Early Intervention: Early diagnosis and treatment, including physical therapy, are essential to maximize shoulder function and prevent complications.
Surgical Options: Surgery may be considered to improve the appearance and function of the shoulder, but it is not always necessary. Surgical goals include scapular repositioning, omovertebral bar resection (if present), and muscle lengthening/release.
Associated Conditions: Undescended scapula can be associated with other conditions, such as Klippel-Feil syndrome, scoliosis, and kidney abnormalities. Evaluation for these associated conditions is important.
Psychological Impact: The cosmetic appearance of the condition can have a psychological impact, especially on children and adolescents. Addressing these concerns is important.
Long-term Management: Regular follow-up with a physician or orthopedic specialist is necessary to monitor shoulder function and address any new or worsening symptoms.