Advertisement

Arthroscopic management of painful and stiff scapulothoracic articulation

      Abstract

      We present the case of a patient who had chronic refractory scapulothoracic pain accompanied by the loss of scapulothoracic motion. Despite intensive physical therapy, the insidious onset of scapulothoracic pain and stiffness progressed. A wide range of diagnostic tests did not show a systemic, anatomic, or neurologic cause for the disorder. Finally, the patient elected to undergo an arthroscopic release and decompression of the scapulothoracic articulation. The patient had a dramatic response to surgery; the pain was gone immediately, and by 4 months after surgery, her scapulothoracic motion was evaluated as symmetric. One year after the surgery, she maintained an active lifestyle and was extremely satisfied with the result. Progressive and painful loss of shoulder motion in the case reported was due to a rare adhesive inflammation of the scapulothoracic bursa, which was successfully treated using arthroscopic resection. Arthroscopy of the scapulothoracic articulation is an option to treat scapulothoracic abnormalities, especially bursitis, but long-term clinical studies are needed to strongly recommend this emerging treatment option.
      Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 19, No 4 (April), 2003: pp E28

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Freedman L
        • Munro RR
        Abduction of the arm in the scapular plane: Scapular and glenohumeral movements. A roentgenographic study.
        J Bone Joint Surg Am. 1966; 48: 1503-1510
        • Inman VT
        • Saunders JB
        • Abbott LC
        Observations on the function of the shoulder joint.
        J Bone Joint Surg. 1944; 26: 1-30
        • Goldberg BA
        • Scarlat MM
        • Harryman II, DT
        Management of the stiff shoulder.
        J Orthop Sci. 1999; 4: 462-471
        • Matsen FA
        • Lippitt SB
        • Sidles JA
        • Harryman II, DT
        Practical evaluation of the management of the shoulder.
        WB Saunders, Philadelphia1994
        • Williams Jr, GR
        • Shakil M
        • Klimkiewicz J
        • Iannotti JP
        Anatomy of the scapulothoracic articulation.
        Clin Orthop. 1999; 359: 237-246
        • Carlson HL
        • Haig AJ
        • Stewart DC
        Snapping scapula syndrome: Three case reports and an analysis of the literature.
        Arch Phys Med Rehabil. 1997; 78: 506-511
        • Kuhn JE
        • Plancher KD
        • Hawkins RJ
        Symptomatic scapulothoracic crepitus and bursitis.
        J Am Acad Orthop Surg. 1998; 6: 267-273
        • Percy EC
        • Birbrager D
        • Pitt MJ
        Snapping scapula: A review of the literature and presentation of 14 patients.
        Can J Surg. 1988; 31: 248-250
        • Parsons TA
        The snapping scapula and subscapular exostoses.
        J Bone Joint Surg Br. 1973; 55: 345-349
        • Samilson RL
        • Morris JM
        • Thompson RW
        Tumors of the scapula.
        J Bone Joint Surg Am. 1967; 49: 202-204
        • Nielsen T
        • Sneppen O
        • Myhre-Jensen O
        • et al.
        Subscapular elastofibroma: A reactive pseudotumor.
        J Shoulder Elbow Surg. 1996; 5: 209-213
        • Strizak AM
        • Cowen MH
        The snapping scapula syndrome: A case report.
        J Bone Joint Surg Am. 1982; 64: 941-942
        • Cameron HU
        Snapping scapulae: A report of three cases.
        Eur J Rheumatol Inflamm. 1984; 7: 66-67
        • Morse BJ
        • Ebraheim NA
        • Jackson WT
        Partial scapulectomy for snapping scapula syndrome.
        Orthop Rev. 1993; 22: 1141-1145
        • Harper GD
        • McIlroy S
        • Bayley JI
        • Calvert PT
        Arthroscopic partial resection of the scapula for snapping scapula: A new technique.
        J Shoulder Elbow Surg. 1999; 8: 53-57
        • Milch H
        Partial scapulectomy for snapping of the scapula.
        J Bone Joint Surg Am. 1950; 32: 561-566