Winging Scapula: Investigating the problem

Physical examination

Mr. Cole will talk to you about your shoulder symptoms and your shoulder's history. He will examine your shoulder and assess your range of movement. Shrugging your shoulders or lifting your arms into certain positions may be difficult, for example. He may also ask you to push against a wall. This simple but effective test shows to what extent your shoulder blade protrudes.

X-ray

If Mr. Cole suspects a bony cause he may request an x-ray. X-rays are particularly good at showing pictures of your bones. They are not so good, however, at showing soft tissue problems. In most cases the X ray will be normal since the majority of cases are due to soft tissue problem.

MRI

MRI stands for Magnetic Resonance Imaging. A non-invasive and painless procedure, it uses a powerful magnet to obtain three dimensional pictures of body structures. It is good at showing soft tissue problems, such as a lesion which may be pressing on a nerve, for example

EMG Studies

An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals. Nerves control the muscles in the body by electrical signals (impulses), and these impulses make the muscles react in specific ways.

Measuring the electrical activity in muscles and nerves can help diagnose conditions that affect muscle tissue (such as muscular dystrophy) or nerves. EMG and nerve conduction studies are often done together to give more complete information.