Scapulothoracic Disorders: Anatomy, Kinematics, Clinical Assessment, and Multimodality Imaging

Shoulder and neck concerns are prevalent musculoskeletal issues prompting medical attention, often stemming from scapulothoracic disorders that can serve as both the cause and consequence of other shoulder abnormalities. Scapular dyskinesis, fractures, benign and malignant masses, and neuropathies are frequently overlooked yet can substantially affect shoulder pain and function, particularly in athletes. Scapulothoracic disorders may lead to and/or be worsened by common shoulder abnormalities including those of the rotator cuff, neighboring bursae, and the glenohumeral articulation and labrum. Imaging is pivotal in the evaluation of scapulothoracic disorders because physical examination can be difficult and confounding. Radiographic studies, including standard and dynamic radiographic assessments, can aid in the detection of osseous deformities and abnormalities in scapular motion. CT allows improved detection of osseous variants and identification of occult fractures or tumors and permits precise measurement. MRI offers detailed evaluation of soft-tissue abnormalities, muscle trophism, and nerve structures. Advanced MRI techniques, tailored acquisitions, and optimal image acquisition parameters are essential for accurate interpretation and diagnosis of scapulothoracic disorders. Given the complex three-dimensional morphology and motion at the scapulothoracic joint, a multimodality imaging approach in conjunction with the clinical history and physical examination is necessary for a comprehensive assessment of the scapulothoracic joint. The radiologist can play an important role in assisting the treating provider in the diagnosis and subsequent management of these complex conditions. ^©RSNA, 2024 Supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.