Arthroscopic management of painful and stiff scapulothoracic articulation.

Abstract

We present the case of a patient who had chronic refractory scapulothoracic pain accompanied by the loss of scapulothoracic motion. Despite intensive physical therapy, the insidious onset of scapulothoracic pain and stiffness progressed. A wide range of diagnostic tests did not show a systemic, anatomic, or neurologic cause for the disorder. Finally, the patient elected to undergo an arthroscopic release and decompression of the scapulothoracic articulation. The patient had a dramatic response to surgery; the pain was gone immediately, and by 4 months after surgery, her scapulothoracic motion was evaluated as symmetric. One year after the surgery, she maintained an active lifestyle and was extremely satisfied with the result. Progressive and painful loss of shoulder motion in the case reported was due to a rare adhesive inflammation of the scapulothoracic bursa, which was successfully treated using arthroscopic resection. Arthroscopy of the scapulothoracic articulation is an option to treat scapulothoracic abnormalities, especially bursitis, but long-term clinical studies are needed to strongly recommend this emerging treatment option.