Operative Management in a Patient with Scapulothoracic Bursitis

Abstract

Scapulothoracic bursitis, an uncommon lesion, has been reported to be a painful disorder of scapulothoracic articulation. The articulation may become inflamed secondary to trauma when overused because of sports or work that requires repetitive or constant movement of the scapula against the posterior chest wall. The bursitis usually appears as a growing mass at the scapulothoracic interface and is often confused with a soft tissue tumor. We report on a patient with scapulothoracic bursitis who underwent surgical excision.

Bilateral cystic lesions of the chest wall: Presentation of scapulothoracic bursitis

“…Soft tissues of the scapulothoracic joint will be damaged by a direct or indirect trauma. In sports like golf, tennis, swimming or in throwing, the syndrome of overuse can appear [4] and also in work which requires repeating or standing movements of the scapula against the posterior thoracic wall [3]. Our patient worked as a rehabilitation worker, her work contributed to her injury.…”

“…In differential diagnostics of the thoracic wall focus in the scapulothoracic region it can be a case of abscess, haematoma, elastofibroma, sarcoma, malignant fibrous histiocytoma or liposarcoma. In differentiation between the scapulothoracic bursitis and tumours of soft tissues of the thoracic wall imaging examinations like computer tomography and magnetic resonance are useful [4]. The Magnetic resonance is the best tool for revelation of pathology of soft tissues.…”

“…The therapy of bursitis can be nonoperative or operative. Conservative treatment includes exercises of the arms, anti-inflammatory drugs, intracystic injections of long-term-acting corticoids or ethanol [4]. Also local hot compresses, relaxation utilization of ultrasound stimulation of nerves [3] belong among further ways of conservative therapy.…”

“…The surgical therapy of bursitis is indicated, if a conservative treatment was shown as unsuccessful [4,2]. Above all it concerns patients with pronounced painfulness, excessive friction between musculus serratus anterior and thoracic wall or with dysfunction of glenohumeral joint [6].…”

“…Above all it concerns patients with pronounced painfulness, excessive friction between musculus serratus anterior and thoracic wall or with dysfunction of glenohumeral joint [6]. The possibilities of operative treatment include open bursectomy, partial scapulectomy and resection of bursa by arthroscopic technique of mini-invasive surgery [4,2]. To the complications connected with the arthroscopic or open bursectomy we classify pneumothorax, haematoma, damage of nervus scapularis a recurrence of bursitis [2].…”