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Scapular winging due to scapular osteochondroma with accessory nerve involvement

We report on a 29-year-old male patient, who presented at our clinic with scapula alata on the right side. The patient also complained of shoulder discomfort, however range of motion of right shoulder was found to be normal. The patient had unremarkable medical and family histories. There was history of gradually increasing asymmetry of upper back for last 2–3 months. In neurological status, we found asymmetry of right upper back with scapular winging, with mild trapezius muscle atrophy. Electrodiagnostic studies, electromyography and nerve conduction studies, showed mild right accessory nerve (XI) compression. Right shoulder and thoracic radiological series were indicated and registrated kyphoscoliotic deformity of the mid-thoracic spine. A right shoulder computed tomography was performed and described a 1.4cm, X 0.3cm solid bone mass at the scapula. The diagnosis of an osteochondroma was stated. A magnetic resonance imaging (MRI) including the right shoulder and scapula confirmed the osteochondroma. (Figure 1) According to the recommendations, due to local compression of XI nervous the operation was recommended to our patient but he refused it.

Scapular winging, osteochondroma, accessory nerve

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