Scapulothoracic bursitis
Scapulothoracic bursitis can mimic other problems. It can be very hard to diagnose and may only be found after other diagnosis have been ruled out. True scapulothoracic bursitis is caused by an abnormal growth or lesion that is located between the scapula and the rib cage. The scapulothoracic joint is located where the scapula or shoulder blade normally would glide along the chest wall as it moves. The bursa is the small sac of fluid that lies between the bones. It is filled with synovial fluid and allows the two bones to move without having friction or pain upon movement.
Bursitis occurs when the bursa becomes inflamed. This inflammation can be caused due to accident or injury. Age and other problems such as osteoarthritis can affect the joint spaces and cause problems such as bursitis. In this particular type of bursitis, there is a structural lesion located between the chest wall and the scapula. This causes friction to take place when the shoulder blade moves along the chest wall. The scapula is not able to move in a fluid motion as it should.
Grinding and snapping sounds often are noticed when this happens. This particular type of bursitis usually takes place after surgery or traumatic injury to the shoulder or the chest wall. Lesions, scar tissue and other tumors are usually the cause of the problems with motion in this disorder.
Scapulothoracic bursitis can be very painful in nature and hard to diagnose as mentioned above. Extensive testing may be needed to make a correct diagnosis in this area. There are fluoroscopic x-ray procedures that can be used to diagnose this issue. CT scans can be utilized in this matter as well.
Symptoms of this problem include noticing a snapping or grinding noise when moving the shoulder in certain ways. The snapping or crepitus and grinding noises may be accompanied by pain and cause the person to have limited movement and mobility in that shoulder and arm.
Once a diagnosis of scapulothoracic bursitis is made there are several treatment options that can be used to take care of this problem. Conservative treatment can be utilized for this issue if the limited mobility and movement are not severe. Pain levels should be evaluated as well. Medications that are used to reduce inflammation can be used for this issue. Oral steroids can be utilized as well to help to reduce the inflammation in the joint space and in the bursa.
There are several surgical options that can be offered to people with this problem. There are arthroscopic procedures that can be done to remove the lesions or tumors that are causing the scapula limited or painful movement. This accompanied with shaving down any bony prominences that might be causing problems with motion usually can take care of the problems that come along with this. Another surgical option that can be offered is to remove the bursa from the joint space. This procedure is called a bursectomy.
Other treatment options to relieve the pain and inflammation in the joint space that can be considered are injections that place steroids and other anesthetic medications into the joint space itself to give the patient immediate relief. These options give a person several treatment routes that they can consider.
Anyone who feels that they might have scapulothoracic bursitis should consult with their physician and have the proper testing done in order to get a correct diagnosis. Once this has been done then treatment options should be discussed. A referral to an orthopedic surgeon may be warranted as well as fluoroscopic radiographs to find the exact cause of the pain and discomfort. The surgeon can go over treatment options which should include both arthroscopic procedures and other types of surgical removal.
Other referrals may include referrals to pain management or to a physician who offers injections into the joint space.
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