Trapezius Muscle

[Son Nguyen]

Hi Birdies!

I was hoping someone could shed some light on this case I scanned yesterday.

Patient lifted a heavy object 2 days ago, now has severe pain and firm swelling over trapezius muscle 10/10.
Also some tenderness over AC jont 8/10. General severe restricted painful movements.

– Rotator Cuff NAD, GHJ NAD
– AC joint distended with echogenic foci within, stable ?synovitis ?arthropathy
– Trapezius muscle enlarged with increased echogenicity.

What would be the cause of trapezius appearance?

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[Stephen Bird]

Howdy,

The AC joint looks degenerative and the patient is 57 years old so this is common.

The trapezius muscle appearance is unusual,

I don’t think I have seen a trapezius tear before but perhaps you have just shown one to me.
Trapezius is such a big muscle I don’t think of it as being a muscle that tears.

The ultrasound appearance is more consistent with a delayed onset muscle soreness (DOMS) event rather than a tear.

Was there a history of repeated lifting on the day causing a muscle overloading injury?

Or was it a single lift?

Steve

[Son Nguyen]

Thanks for the reply Steve.

I can’t recall exactly what he was doing beforehand. He mentioned lifting quite a heavy gate over a short period only.
DOMS could well be a good differential. His extreme tenderness and restricted ROM was also odd.

[Stephen Bird]

Yes, it is an unusual injury,

Not a muscle I see getting into trouble often,

If he has an MRI it would be interesting to see the result.

Steve

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