II. Epidemiology

  1. Uncommon condition

III. Etiology

  1. Scapula is cushioned by surrounding musculature
    1. Serratus anterior
    2. Subscapularis
  2. Scapula is poorly protected in a few locations
    1. Medial border
    2. Superior and Inferior Angles

IV. Differential Diagnosis for crepitation at Shoulder

  1. Tumors of Scapula or Ribs
  2. Bursae between bones
  3. Poor Posture with sagging of Shoulder joint

V. Symptoms

  1. Gradual progression following ShoulderTrauma
  2. Snapping Sensation at scapulothoracic articulation
    1. Palpable
    2. Painful
    3. Audible grating sound

VI. Radiology: Shoulder XRay (AP, Lateral and Oblique)

  1. Assess for exostoses and tumors

VII. Management

  1. Physical Therapy
  2. Rest
  3. Local Corticosteroid Injection
  4. Correct poor Posture
  5. Surgery Indications
    1. Pain, dysfunction refractory to conservative therapy
      1. Remove involved area of Scapula
    2. Secondary cause due to tumor or exostosis

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