Clinical and Imaging Features of Distended Scapulothoracic Bursitis

Abstract

Distended scapulothoracic bursae without scapular snapping resemble soft tissue tumors. They have some specific MR findings; therefore, precise recognition of these findings is important to avoid misdiagnoses and unnecessary treatments.

Operative Management in a Patient with Scapulothoracic Bursitis

“…Two major (anatomic) and four minor (adventitial) bursas have been described for the scapulothoracic articulation. These bursas allow a gliding scapulothoracic motion [1,2]. The major bursas include the scapulothoracic bursa (also called the infraserratus bursa) and the subscapularis bursa.…”

“…The major bursas include the scapulothoracic bursa (also called the infraserratus bursa) and the subscapularis bursa. The former is located between the serratus anterior muscle and the chest wall, and the latter is located between the serratus anterior muscle and the subscapularis muscle [1]. These bursas can become inflamed secondary to trauma when overused during sports (e.g., throwing, swimming, tennis, and golf), or work that requires repetitive or constant movement of the scapula against the posterior chest wall [2].…”

“…Trauma may be directly caused, as an injury from a motor vehicle accident, or caused indirectly, as a result of a fall to an outstretched extremity that injures the soft tissues of the scapulothoracic articulation [1,2]. Clinical evaluation of the painful shoulder begins with a thorough history check and physical examination.…”

“…The lesion usually appears as a well-demarcated cystic mass between the serratus anterior muscle and the chest wall. Differential diagnostic considerations of chest wall masses in the scapulothoracic region include elastofibroma, abscess, hematoma, and sarcoma, such as malignant fibrous histiocytoma, and liposarcoma [1]. Magnetic resonance imaging is more useful for distinguishing between scapulothoracic bursitis and the soft tissue tumor of the chest wall because the recognition of hemorrhagic findings in the bursa is easier.…”

Scapulothoracic Anatomy and Snapping Scapula Syndrome

“…Three-dimensional CT is especially helpful in characterizing subtle bony irregularities that are often responsibly for scapulothoracic irritation and ultimately, snapping scapula syndrome [54]. MRI is the study of choice for characterizing soft tissue pathology [55, 56]. This study is especially helpful in evaluation of inflamed bursae as well as in the evaluation of potential soft tissue tumors.…”