Axillary web syndrome: an overlooked cause of shoulder pain

Year 2019, Volume: 44 Issue: 1, 255 - 259, 31.03.2019

Bekir Tetik Kadir Songür Ayhan Aşkın

https://doi.org/10.17826/cumj.457220

Cited By: 1

Abstract

Axillary
web syndrome (AWS) is a clinical syndrome that usually seen after surgical intervention
to axillary region. Fibrosis surrounded sclerotic vein and lymphatic tissue
(cording), can extends from axilla to arm and hand. AWS can limit off shoulder
range of motion (ROM) and can be the cause of shoulder pain. In the case we
share, it is noteworthy that any predisposing factor does not exist.
41-year-old male patient was admitted our outpatient clinic with pain and
feeling of tension on the right axilla which started 2 weeks ago during the
daily activities. On the physical examination there was a subcutaneous cord
that was visible from the right axillary region to the middle of the right arm.
His right shoulder movements were limited and painful. The patient was
prescribed oral nonsteroidal antiinflammatory drug (NSAID), electrotherapy program
and shoulder stretching/strengthening exercises. After 2 months, on the
re-examination, his right shoulder ROM was painless and in normal range; the
subcutaneous cording had completely recovered. Within our knowledge, our case
is the second case, whose etiology is unknown in the literature. Clinicians
should consider AWS, in differential diagnosis in patients with axillary
region/shoulder pain and shoulder ROM limitation. These patients may benefit
from appropriate combination therapies that include physical therapy modalities
and NSAIDs.

Keywords

Axillary web syndrome, pain, cording, physical therapy

Aksiller web sendromu: omuz ağrısının gözden kaçan nedeni

Abstract

Aksiller
web sendromu (AWS), genellikle aksiller bölgeye yapılan girişim sonrası
görülür. Fibrozis ile çevrelenmiş skleroze ven ve lenfatik dokular (kording)
aksilladan başlayıp, kola ve ele kadar uzanabilir. Omuz eklem hareket
açıklığını (EHA) kısıtlayan ve ağrıya sebep olabilen klinik bir durumdur.
Paylaşacağımız olguda ise mevcut bir predispozan faktörün olmayışı dikkat
çekicidir. İki hafta önce günlük aktivite sırasında sağ koltuk altında
gerginlik ve ağrı hisseden 41 yaşında erkek hasta polikliniğimize başvurdu.
Muayenesinde sağ aksiller bölgeden başlayıp sağ kol ortasına kadar uzanan gözle
görülebilen düzeyde cilt altı kord görünümü mevcuttu. Sağ omuz hareketleri
kısıtlı ve ağrılıydı. Hastaya oral non-steroidal antiinflamatuar ilaç (NSAİİ),
elektroterapi programı ve omuz germe/güçlendirme egzersizleri reçete edildi.
Hastanın 2 ay sonraki kontrol muayenesinde omuz EHA ağrısız, tam açıktı ve cilt
altındaki kord bulgusu tamamen düzelmişti. Bilgimiz dahilinde olgumuz
literatürdeki etiyolojisi bilinmeyen ikinci vakadır. Klinisyenlerin aksiller
bölgede ve omuzda ağrı, omuz EHA’da kısıtlılık olan hastalarda AWS’i ayırıcı tanıda
düşünmesi gerekmektedir. Bu hastalar uygun fizik tedavi modaliteleri ve
NSAİİ’ın kombine kullanıldığı tedavilerden fayda görebilmektedir.

Keywords

Aksiller web sendromu, ağrı, kord, fizik tedavi

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