Snapping scapula

Scapulothoracic bursitis, otherwise known as snapping scapula is an uncommon disorder which causes pain an crepitance in the upper back and shoulder blade (scapula). It is due to irritation of the bursa (fluid filled sack) under the scapula. It can be related to malformation of the scapula or malunion of a prior scapular fracture as well as poor shoulder mechanics.

Patients with scapulothoracic bursitis complain of pain and grinding at the inferior angle of the scapula. It generally occurs during the late cocking and acceleration phases of throwing in the throwing athlete.

Treatment

Treatment begins with rest, shoulder exercises, antiinflammatory medications, and cortisone injections. Patients who fail conservative treatment may consider surgical intervention which includes excision of the thickened bursa. Surgery is rarely needed.

Risks of surgery include but are not limited to: Infection, nerve or vascular injury, Incomplete releif of pain, Incomplete return of funtion, Shoulder stiffness, Incisional scar (cosmesis), CRPS, Medical and anesthesia risks including heart attack, stroke and death. Althought complications can occur most patients are satisfied with their surgical outcomes.

With both operative and non operative treatment patients are placed in a sling for comfort, and do not do any overhead motion initially. Patients may remove the sling for elbow, wrist and hand range of motion exercises. Fracture healing generally takes 6-10 weeks. Studies have shown the mean time for fracture healing to be 28.4 weeks for non-operative treatment and 16.4 weeks for operative treatment for displaced clavicle fractures.

Further information about Scapulothoracic Bursitis can be found at the following sites:

Every person and their particular circumstances are different so the treatment for your shoulder may be different than those discussed above. Please read this information carefully. Write down any questions that you have about your injury and its treatment and discuss them with your orthopaedic surgeon.

Synonyms: 
scapulothoracic bursitis, snapping scapula, scapulothoracic crepitus, washboard syndrome

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