• J Clin Med · Nov 2018

    Morphological Aspects in Ultrasound Visualisation of the Suprascapular Notch Region: A Study Based on a New Four-Step Protocol.

    • Hubert Jezierski, Michał Podgórski, Grzegorz Wysiadecki, Łukasz Olewnik, Raffaele De Caro, Veronica Macchi, and Michał Polguj.
    • Department of Orthopedics and Traumatology, Ministry of the Interior Hospital, Północna 42, 91-245 Łódź, Poland. hjez@o2.pl.
    • J Clin Med. 2018 Nov 27; 7 (12).

    BackgroundSonographic evaluation of the suprascapular notch (SSN) region is clinically important, because it is the most common location for performing suprascapular nerve block. The aim of the study was to describe the morphology of the SSN region based on ultrasound examination and in accordance with the patients' body mass index (BMI).Material And MethodsThe SSN region was sonographically examined in 120 healthy volunteers according to our new four-step protocol. The morphometry of the SSN and the neurovascular bundle was assessed, and patients' BMI were calculated. The shape of the suprascapular notch was classified based on its superior transverse diameter (STD) and maximal depth (MD).ResultThe type III scapular notch was the most prevalent (64%). The BMI was higher in type IV/V (27.38 ± 3.76) than in type I (24.77 ± 3.49). However, no significant differences were observed in the distribution of SSN notch types with regard to BMI (p = 0.0536). The suprascapular artery was visualised in all of the recognised SSNs, while the suprascapular vein and nerve were visualised only in 74.9% and 48.1% of the SSNs, respectively. The suprascapular nerve was significantly thicker on the right side (3.5 +/- 1.1 mm) than on the left (1.3 +/- 0.4 mm) (p = 0.001). In contrast, the suprascapular vein (1.5 +/- 0.9 mm) was found to be a significantly wider on the left side than the right (1.2 +/- 0.7 mm) (p = 0.001).ConclusionOur original four-step sonographic protocol enabled characterising the morphology of the SSN region, despite the SSN notch types. The suprascapular artery is the best sonographic landmark for the suprascapular notch region. No significant differences were found between sides regarding the thickness of the soft tissue above the suprascapular nerve and vessels. Recognition of the SSN morphology is not affected by the BMI.

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