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April 24, 2012
Scapular winging can be due to paralysis of the serratus anterior (long thoracic nerve, C5–7), trapezius (spinal accessory nerve), or rhomboid (dorsal scapular nerve, C4–5) muscles. Medial winging, due to serratus anterior weakness, is seen with pushing the arms forward against a wall. Lateral winging is due to weakness of either the trapezius, seen with abduction of the arm higher than 90 degrees, or the rhomboids, accentuated by arm extension from a fully flexed position.
1. Martin RM, Fish DE. Scapular winging: anatomical review, diagnosis, and treatments. Curr Rev Musculoskelet Med 2008; 1:1–11.
Submitted by: Mohamed Kazamel, MD and Paula Province, MD
Disclosure: Drs. Kazamel and Province report no disclosures.
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