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The scapulocostal syndrome.

L J Fourie

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |June 15, 1991
    PubMed
    Summary

    Scapulocostal syndrome, characterized by cervicobrachial pain, is a distinct fibromyalgia entity linked to serratus posterior superior muscle enthesopathy. Conservative treatment, including injections and physical therapy, proved highly effective in most patients.

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    Area of Science:

    • Orthopedics
    • Rheumatology
    • Pain Medicine

    Background:

    • Scapulocostal syndrome is an under-recognized condition causing significant pain.
    • Fibromyalgia encompasses a spectrum of pain disorders, including scapulocostal syndrome.
    • Understanding the etiology of scapulocostal syndrome is crucial for effective management.

    Purpose of the Study:

    • To clinically investigate 201 cases of scapulocostal syndrome.
    • To identify the primary pain source and associated factors.
    • To evaluate the efficacy of conservative and surgical treatments.

    Main Methods:

    • Clinical study of 201 patients diagnosed with scapulocostal syndrome.
    • Analysis of presenting symptoms, particularly cervicobrachial pain.
    • Assessment of conservative treatment: intralesional steroid-analgesic injection and physical rehabilitation.
    • Evaluation of a novel surgical procedure, 'serratotomy', for refractory cases.

    Main Results:

    • Pain was the universal presenting symptom, predominantly cervicobrachial (90%).
    • Scapulocostal syndrome was identified as a definable entity within fibromyalgia.
    • The primary pain origin was enthesopathy of the serratus posterior superior muscle (76.5% had physical degeneration).
    • Conservative treatment achieved a 95.9% success rate.
    • Surgical 'serratotomy' yielded excellent results in 6 patients with failed conservative treatment.

    Conclusions:

    • Scapulocostal syndrome is a distinct fibromyalgia entity originating from serratus posterior superior muscle enthesopathy.
    • Conservative management, including injections and rehabilitation, is highly effective.
    • Surgical intervention (serratotomy) offers a viable option for refractory cases.

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