Scapulothoracic Bursitis: When Conservative Treatment Has Not Resolved Symptoms
Scapulothoracic bursitis causes persistent pain and crepitus at the scapulothoracic interface. For most patients a structured course of nonoperative care resolves both symptoms — but a subset do not reach the goals of that initial line despite completing it in full.
Previous treatment line — goals not met
A complete nonoperative programme was undertaken: rest and activity modification, systemic nonsteroidal anti-inflammatory drugs, a comprehensive shoulder rehabilitation programme (scapular strengthening, postural reeducation, and core strength and endurance) sustained for at least 3 to 6 months, local modalities, and corticosteroid with local anaesthetic injection to the scapulothoracic bursa.
The goals of that line — resolution of scapulothoracic pain and resolution of scapulothoracic crepitus — were not achieved, warranting progression to the next protocol.
Next-step approach (partial overview)
When nonoperative measures have not resolved symptoms and the diagnosis is certain, surgical management is the next consideration. The full protocol specifies the operative approach and the criteria that guide its selection.
The complete structured regimen is available via the link below.
Treatment goals
Resolution of scapulothoracic pain · Resolution of scapulothoracic crepitus
References
DOI: 10.1177/1941738109338359
- Most patients improve with nonoperative measures, but for patients who fail nonoperative measures and for whom the diagnosis is certain, surgery may be beneficial.
- Operative options include partial scapulectomy and open versus arthroscopic bursectomy.
- Most authors have recommended partial scapulectomy or resection of the superomedial angle of the scapula in patients with scapular crepitus and pain caused by bony incongruity.
- Each of the 17 patients reported resolution of the painful crepitus sensation.
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