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Supraspinous Fossa

fossa supraspinata

The supraspinous fossa is the smaller posterior scapular depression above the scapular spine, providing the origin of the supraspinatus muscle. It is bounded superiorly by the superior scapular border and the suprascapular notch (where the suprascapular nerve enters), inferiorly by the scapular spine, and laterally by the superior glenoid neck. The suprascapular artery passes over the suprascapular ligament (the nerve passes under it) to enter the fossa.

Region: Shoulder

Clinical Relevance

Clinical Notes

Supraspinatus atrophy from suprascapular nerve compression at the suprascapular notch (by a ligament variant, cyst, or hypertrophy) or from massive rotator cuff tears produces visible hollowing above the scapular spine. The suprascapular notch block targets the nerve here for shoulder analgesia. Fatty infiltration of the supraspinous fossa on MRI (Goutallier grading) predicts poor rotator cuff repair outcomes, guiding surgical decision-making between repair and arthroplasty.

Pathology

Common Injuries & Conditions

Suprascapular Nerve Entrapment at Suprascapular Notch

Compression of the suprascapular nerve at the suprascapular notch by a calcified ligament or ganglion produces supraspinatus and infraspinatus weakness and wasting, reproduced by shoulder cross-body adduction stretching the nerve at the notch, managed by suprascapular notch release through open or arthroscopic transection of the ligament.