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Symptomatic scapulothoracic crepitus and bursitis

J E Kuhn1, K D Plancher, R J Hawkins

  • 1Division of Sports Medicine, Section of Orthopaedic Surgery, University of Michigan Medical Center, Ann Arbor, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|October 1, 1998
PubMed
Summary

Scapulothoracic crepitus and bursitis cause painful grinding or snapping sounds during shoulder blade motion. Treatment ranges from exercises to surgery for severe cases.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Musculoskeletal Disorders

Background:

  • Scapulothoracic crepitus and bursitis are painful conditions affecting the scapulothoracic articulation.
  • Crepitus involves grinding/snapping noises with motion, potentially causing pain.
  • Bursitis presents as pain and swelling of the bursae, often accompanying crepitus but can be isolated.

Purpose of the Study:

  • To review the causes, presentation, and treatment options for scapulothoracic crepitus and bursitis.
  • To highlight the relationship between symptomatic crepitus and bursitis.
  • To discuss the efficacy of conservative and surgical interventions.

Main Methods:

  • Review of literature on scapulothoracic crepitus and bursitis.
  • Analysis of causes including bone/soft tissue pathology and articulation congruence issues (e.g., scoliosis, kyphosis).

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  • Evaluation of treatment strategies: nonoperative (postural/strengthening exercises, local modalities) and operative (partial scapulectomy, bursectomy).
  • Main Results:

    • Conservative treatment is highly effective for soft-tissue related crepitus.
    • Osseous lesions or failed conservative treatment may necessitate surgical intervention.
    • Partial scapulectomies and scapulothoracic bursectomies (open and arthroscopic) show satisfactory outcomes in selected patients.

    Conclusions:

    • Scapulothoracic crepitus and bursitis require a tailored treatment approach based on etiology.
    • Nonoperative management is the first line of treatment.
    • Surgical options provide viable alternatives when conservative methods fail or for specific osseous pathologies.