Diagnosis and Treatment of Scapulocostal Syndrome

Russek, Allen S.

doi:10.1001/jama.1952.03680010031007

Cited by 16 publications

(4 citation statements)

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“…[49][50][51] Some patients will have no pain, 51 whereas others may have an extreme tenderness at the superior angle and medial border of the scapula. [48][49][50][51]63,65,67,74 This pain will commonly be associated with a palpable or audible crepitus in the scapulothoracic region. The patient may or may not complain of a feeling of fatigue before the onset of symptoms.…”

Section: Diagnosismentioning

confidence: 99%

Nonoperative and Operative Management of Snapping Scapula

2004

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Snapping scapula is a painful crepitus of the scapulothoracic articulation. This crepitus is a grinding or snapping noise with scapulothoracic motion that may or may not accompany pain. This condition is commonly seen in overhead-throwing athletes. Treatment of patients with this syndrome begins with nonoperative methods; when nonoperative treatment fails, several surgical options exist. This article will discuss both nonoperative and operative management of this common shoulder condition.

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Section: Diagnosismentioning

confidence: 99%

Nonoperative and Operative Management of Snapping Scapula

2004

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“…35 Some patients have no pain, 49 whereas others may have an extreme tenderness at the superior angle and medial border of the scapula. 47,48,63,64,77 In severe cases, patients may report pain at rest. In addition, scapulothoracic crepitus is bilateral in some patients.…”

Section: Diagnosismentioning

confidence: 99%

Clinical Management of Scapulothoracic Bursitis and the Snapping Scapula

Conduah

Baker

2010

Sports Health: A Multidisciplinary Approach

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Context:Symptomatic scapulothoracic bursitis and crepitus are disorders of the scapulothoracic articulation that are often poorly understood. They can be a source of persistent pain and dysfunction in the active overhead throwing athlete. It is important to distinguish between scapulothoracic bursitis and scapulothoracic crepitus. Scapulothoracic bursitis refers to inflammation of the bursae secondary to trauma or overuse owing to sports activities or work. Scapulothoracic crepitus is defined by a grinding, popping, or thumping sound or sensation secondary to abnormal scapulothoracic motion.Evidence Acquisition:This article presents the causes, diagnosis, and management of these shoulder conditions in a manner that is relevant to clinicians, athletic trainers, and physical therapists, and it reviews relevant studies to determine the consensus on nonoperative treatment, as well as open and arthroscopic surgical treatment.Results:The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, osseous abnormalities, muscle atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses; however, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be nonoperative. Surgical treatment options include partial scapulectomy or resection of the superomedial angle of the scapula, open bursal resection, and arthroscopic bursectomy. Despite the lack of agreement among orthopaedic surgeons concerning which procedure is best for treating symptomatic scapulothoracic bursitis and crepitus, most reports have demonstrated good to excellent outcomes in a significantly high percentage of patients.Conclusion:Clearly, the best initial approach to these conditions is a nonoperative treatment plan that combines scapular strengthening, postural reeducation, and core strength endurance. The addition of local modalities, nonsteroidal anti- inflammatory drugs, and localized injections may also be helpful. If an appropriate trial of nonoperative management proves unsuccessful, surgical correction can produce good results.

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“…Proper posture, habits of ‘falling into gravity’ with increasing ages, is still believed to be a state of musculoskeletal balance that involves a minimal amount of stress or strain to the body [10, 25]. Poor posture is defined as increased forward head [22], greater thoracic kyphosis [8], and a more anterior shoulder position [4].…”

Section: Introductionmentioning

confidence: 99%