Differential Diagnosis for Scapula Winging in an 18-year-old
Single Most Likely Diagnosis
- Muscular weakness or imbalance: This is often due to overuse or poor posture, leading to weakness in the muscles that stabilize the scapula, such as the serratus anterior or trapezius muscles. It is common in young adults and can be related to sports or daily activities.
Other Likely Diagnoses
- Trauma or injury to the scapular stabilizing muscles
- Neurological conditions affecting the long thoracic nerve (which innervates the serratus anterior muscle) or the spinal accessory nerve (which innervates the trapezius muscle)
- Poor posture or scaparothoracic dyskinesis
Do Not Miss Diagnoses
- Neurological disorders: Such as spinal cord injuries, bristlecone (poliomyelitis), or other conditions that could lead to muscle weakness
- Tumors or cysts: That could compress nerves affecting scapular stabilization
- Infections: Such as osteomyelitis or abscesses that could affect the scapula or surrounding muscles
Rare Diagnoses
- Congenital conditions: Such as Sprengel's deformity, where the scapula is elevated due to abnormal development
- Fibromathic conditions: Such as fibromathic facicic (also known as desmoid tumors) affecting the scapular region
- Metabolic bone diseases: Such as osteoporosis or rickets, which could affect the scapula's structure and stability