Differential Diagnosis for Wing Scapula Injury
Single Most Likely Diagnosis
- Scapular Winging due to Serratus Anterior Weakness: This is often the most common cause of wing scapula, resulting from weakness or paralysis of the serratus anterior muscle, which can be due to injury to the long thoracic nerve.
Other Likely Diagnoses
- Trapezius Muscle Weakness: Weakness in the trapezius muscle, often due to spinal accessory nerve injury, can also lead to scapular winging.
- Rhomboid Muscle Weakness: Injury or weakness affecting the rhomboid muscles can cause scapular winging, though this is less common than serratus anterior or trapezius issues.
- Scapulothoracic Bursitis: Inflammation of the bursae around the scapulothoracic joint can cause pain and lead to scapular winging due to discomfort rather than true muscle weakness.
Do Not Miss Diagnoses
- Spinal Cord Injury: While less common, any form of scapular winging could potentially be a sign of a more serious underlying condition such as a spinal cord injury affecting the nerves that control the muscles of the shoulder girdle.
- Tumor or Mass Compressing Nerves: A tumor or mass compressing the long thoracic nerve, spinal accessory nerve, or other nerves could lead to muscle weakness and scapular winging.
Rare Diagnoses
- Polio or Other Neuromuscular Diseases: In areas where polio has not been eradicated or in cases of other neuromuscular diseases, these conditions could potentially lead to scapular winging due to muscle weakness.
- Congenital Conditions: Certain congenital conditions affecting the musculoskeletal system could result in scapular winging, though these are typically identified early in life.
- Scapular Fracture: A fracture of the scapula itself could potentially lead to winging, especially if it affects the scapular body or involves significant displacement.