Symptomatic Ventromedial Scapular Osteochondroma Presenting with Restriction of Shoulder Movements: A Case Report

Ventromedial scapular osteochondroma is an uncommon cause of scapulothoracic impingement and shoulder restriction in children. Because of its deep anatomical location, diagnosis is often delayed, particularly in pediatric patients with minimal symptoms.

A 9-year-old male presented with a gradually progressive, painless swelling over the left scapular region associated with difficulty in overhead shoulder movements for 1 year. Clinical examination revealed a firm, immobile bony mass over the posterior scapula with terminal restriction of shoulder abduction and forward elevation. Computed tomography demonstrated a pedunculated osteochondroma arising from the ventromedial surface of the scapula. The lesion was excised completely through a posterior approach. Postoperatively, the patient demonstrated marked improvement in shoulder range of motion with return to normal daily activities.

Timely surgical excision restores shoulder function and prevents progression of mechanical symptoms. Although rare, ventromedial scapular osteochondroma should be considered in the differential diagnosis of restricted shoulder mobility with unexplained scapular prominence in children, where it may mimic snapping scapula syndrome.