Scapulothoracic Bursitis

Overview

For patients in Richmond, VA seeking specialized care, understanding the mechanics of scapulothoracic bursitis is the first step toward recovery. This condition is also sometimes referred to as snapping scapula syndrome. The scapula is unique because it glides over the rib cage rather than articulating with another bone directly. To facilitate this gliding, there are bursa sacs (fluid-filled cushions) between the muscle layers. Scapulothoracic bursitis can occur when this gliding surface becomes inflamed or roughened for any reason. It can be a soft-tissue problem (thickened bursa) or a bony problem (a bone spur on the rib or scapula hooking into the muscle).

Symptoms

  • Audible Noise: A loud crunch, grind, or pop when rotating the shoulder.

  • Pain at the Superomedial Angle: Pain at the top inner corner of the shoulder blade.

  • "Washboard" Sensation: A feeling of vibration or friction during movement.

Non-Operative Management

  • Cortisone Injection: An injection directly into the scapulothoracic bursa can both temporarily relieve pain and therefore provide confirmation that this is the correct diagnosis.

  • Postural Rehab: Strengthening the periscapular muscles to lift the scapula off the chest wall, reducing friction, might provide some benefit.

  • Medication: Anti-inflammatory medication such as NSAIDs may help alleviate the pain of this syndrome.

When is Surgery Needed?

  • Bony Impingement: If X-rays or CT scans confirm a bone spur or a hooked superomedial angle digging into the ribs.

  • Fibrosis: If the bursa has become permanently thickened and painful despite injections.

Surgical Solutions