Inferior Paralabral Cyst Causing Suspected Axillary Nerve Compression in the Quadrilateral Space: An MRI-Based Case Report

Paralabral cysts are commonly associated with labral tears and can compress nearby neurovascular structures. Inferior paralabral cysts are rare and may extend into the quadrilateral space, placing the axillary nerve at risk. We report a case of a 34-year-old man with severe shoulder pain and minimal objective neurologic deficits in whom MRI demonstrated an anteroinferior labral tear with an associated paralabral cyst extending into the quadrilateral space with suspected compression of the axillary nerve. Although surgical intervention was initially planned, the patient experienced spontaneous resolution of symptoms with conservative management. This case highlights the role of MRI in identifying atypical paralabral cysts and suggests that select patients without significant neurologic deficits may be managed nonoperatively.