Scapula alata

winging of scapula

Winging scapula

The scapula alata (from Latin scapula shoulder blade and Ala wing) describes the wing-like protrusion of the shoulder blade (scapula) from the wall of the chest (thorax) on one or both sides (scapulae alatae ). The scapula alata is a symptom of various diseases.

Forms and occurrences

Different forms of the scapula alata can be distinguished depending on the paralyzed muscles. The clinical examination can be used to distinguish between the various forms on the basis of certain movements.

If the serratus anterior muscle is paralyzed (innervation by the long thoracic nerve ), a medial position of the shoulder blade is characteristic. The scapula alata is particularly evident when pressing against a wall with the arms extended forward and when the arm is abduced over 90 ° (arm elevation).

Paralysis of the rhomboid muscles ( rhomboideus major and rhomboideus minor ), on the other hand, leads to a lateral position of the shoulder blade. The medial edge of the shoulder blade deviates inward, especially with arm abduction. However, an increase in arm elevation is not typical. The rhomboid muscles are supplied by the dorsal scapular nerve .

The paralysis of the trapezius muscle (innervation by the accessory nerve ) leads, according to the physiological function, to a lateral position of the shoulder blade with protruding of the medial edge. The scapula alata does not increase in trapezius palsy due to arm abduction and arm elevation.

In addition to lesions of individual nerves supplying the muscles, the scapula alata is a sign of neuralgic shoulder amyotrophy and numerous muscle diseases that involve the shoulder girdle muscles (e.g. limb girdle dystrophy and facioscapulohumeral muscular dystrophy ).

Sometimes the scapula alata can also be part of a rare syndrome, such as the otofacio-cervical syndrome .

Web links

• Image of a bilateral scapula alata in facioscapulohumeral muscular dystrophy

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• JP Sieb, B. Cabinet: Neuromuscular Diseases. Kohlhammer, Stuttgart 2009, ISBN 978-3-17-018381-0 , p. 19.
• J. Klingelhöfer, M. Rentrop: Clinical guidelines for neurology and psychiatry. Elsevier, Munich 2003, 3rd edition, ISBN 978-3-437-23140-7 , p. 497.
• Christoph Heesen: Neuro- DD. de Gruyter, Berlin 1998, ISBN 978-3-11-016214-1 , p. 125.