Snapping Scapula Syndrome Resulting from a Subscapular Osteochondroma: Case Report and Literature Review
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Published:
Dec 20, 2023
Keywords:
Exostosis, osteochondroma, snapping scapula syndrome, scapulothoracic pathology
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Abstract
Snapping scapula syndrome is a rare pathology first described by Boinet in 1867. Its pathogenesis is caused by an incongruency in the thoracic scapular joint, associated with multiple causes including bursitis, exostosis, bone mass, fibrotic tissue or muscular abnormalities, defective consolidation of fractures or anatomical rib or scapular fractures. The purpose of this article is to present a clinical case of an adolescent with incapacitating clinical pain in the right scapular region, as well as a deformity at this level that had evolved for more than 4 years, and which, when diagnostic tests were performed, revealed a subscapular bone mass suggestive of a single large osteochondroma measuring more than 2.5 cm x 4 cm x 4 cm.. A review and update of the literature on the diagnosis and current treatment of this pathology is made.
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How to Cite
Pinzón Escobar, J. A., Castilla Pérez, R. M., & Flórez Hernández, D. M. (2023). Snapping Scapula Syndrome Resulting from a Subscapular Osteochondroma: Case Report and Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(6), 662-668. https://doi.org/10.15417/issn.1852-7434.2023.88.6.1724
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Case Presentations
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References
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3. de Carvalho SC, Castro A do AE, Rodrigues JC, Cerqueira WS, Santos D do CB, Rosemberg LA. Snapping scapula syndrome: pictorial essay. Radiol Bras 2019;52(4):262-7. https://doi.org/10.1590/0100-3984.2017.0226
4. Frank RM, Ramirez J, Chalmers PN, McCormick FM, Romeo AA. Scapulothoracic anatomy and snapping scapula syndrome. Anat Res Int 2013;2013:635628. https://doi.org/10.1155/2013/635628
5. Gaskill T, Millett PJ. Snapping scapula syndrome: diagnosis and management. J Am Acad Orthop Surg
2013;21(4):214-24. https://doi.org/10.5435/JAAOS-21-04-214
6. Williams CH, Jamal Z, Sternard. BT. Bursitis [Internet]. StatPearls; 2022. Disponible en:
https://www.ncbi.nlm.nih.gov/books/NBK513340/
7. Srikumaran U, Wells JH, Freehill MT, Tan EW, Higgins LD, Warner JJP. Scapular winging: A great masquerader of shoulder disorders: AAOS exhibit selection: AAOS exhibit selection. J Bone Joint Surg Am 2014;96(14):e122. https://doi.org/10.2106/JBJS.M.01031
8. Tepelenis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, et al. Osteochondromas: An updated review of epidemiology, pathogenesis, clinical presentation, radiological features, and treatment options. In Vivo 2021;35(2):681-91. https://doi.org/10.21873/invivo.12308
9. Ngongang FO, Fodjeu G, Fon AC, Fonkoue L, Guifo ML, Bitang A, et al. Surgical treatment of rare case of scapula osteochondroma in a resource limited setting: A case report. Int J Surg Case Rep 2019;61:130-4.
https://doi.org/10.1016/j.ijscr.2019.07.015
10. Kaiser CL, Yeung CM, Raskin K, Gebhardt MC, Anderson ME, Lozano-Calderón SA. Tumors of the scapula: A retrospective analysis identifying predictors of malignancy. Surg Oncol 2020;32:18-22.
https://doi.org/10.1016/j.suronc.2019.10.020
11. Khan Z, Gerrish AM, Grimer RJ. An epidemiological survey of tumour or tumour like conditions in the scapula and periscapular region. SICOT J 2016;2:34. https://doi.org/10.1051/sicotj/2016023
12. Boinet J. Snapping scapula. Bulletin Societe Imperiale Chirurugie 1867;8:458.
13. Song Y, Liu J, Cao L, Yu B-H, Sun T, Shi L, et al. Clinical and imaging features of tumors in the scapula. Curr Med Imaging Rev 2022;18(6):674-83. https://doi.org/10.2174/1573405617666210901144924
14. Park SB, Ramage. JL. Winging of the scapula. StatPearls; 2022. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK541005/
15. Gooding BWT, Geoghegan JM, Wallace WA, Manning PA. Scapular winging. Shoulder Elbow 2014;6(1):4-11. https://doi.org/10.1111/sae.12033
16. Edelson JG. Variations in the anatomy of the scapula with reference to the snapping scapula. Clin Orthop Relat Res 1996;322(322):111-5. https://doi.org/10.1097/00003086-199601000-00013
17. Lehtinen JT, Macy JC, Cassinelli E, Warner JJP. The painful scapulothoracic articulation: Surgical management. Clin Orthop Relat Res 2004;423:99-105. https://doi.org/10.1097/01.blo.0000128647.38363.8e
18. Williams GR, Ramsey ML, Wiesel SW. Técnicas quirúrgicas en hombro y codo. Baltimore, MD: Wolters Kluwer Health; 2011.
19. Lazar MA, Kwon YW, Rokito AS. Snapping scapula syndrome. J Bone Joint Surg Am 2009;91(9):2251-62.
https://doi.org/10.2106/JBJS.H.01347
20. Kuhn JE, Plancher K, Hawkins RJ. Symptomatic scapulothoracic crepitus and bursitis. J Am Acad Orthop Surg 1998;6(5):267-73. https://doi.org/10.5435/00124635-199809000-00001
21. Kuhne M, Boniquit N, Ghodadra N, Romeo AA, Provencher MT. The snapping scapula: diagnosis and treatment. Arthroscopy 2009;25(11):1298-311. https://doi.org/10.1016/j.arthro.2008.12.022
22. Chan BK, Chakrabarti AJ, Bell SN. An alternative portal for scapulothoracic arthroscopy. J Shoulder Elbow Surg 2002;11(3):235-8. https://doi.org/10.1067/mse.2002.121767
23. Millett PJ, Gaskill TR, Horan MP, van der Meijden OA. Technique and outcomes of arthroscopic scapulothoracic bursectomy and partial scapulectomy. Arthroscopy 2012;28(12):1776-83.
https://doi.org/10.1016/j.arthro.2012.05.889
24. Conduah AH, Baker CL 3rd, Baker CL Jr. Clinical management of scapulothoracic bursitis and the snapping scapula. Sports Health 2010;2(2):147-55. https://doi.org/10.1177/1941738109338359
25. Pearse EO, Bruguera J, Massoud SN, Sforza G, Copeland SA, Levy O. Arthroscopic management of the painful snapping scapula. Arthroscopy 2006;22(7):755-61. https://doi.org/10.1016/j.arthro.2006
26. Pavlik A, Ang K, Coghlan J, Bell S. Arthroscopic treatment of painful snapping of the scapula by using a new superior portal. Arthroscopy 2003;19(6):608-12. https://doi.org/10.1016/s0749-8063(03)00171-3
27. Nicholson GP, Duckworth MA. Scapulothoracic bursectomy for snapping scapula syndrome. J Shoulder Elbow Surg 2002;11(1):80-5. https://doi.org/10.1067/mse.2002.120807
28. Harper GD, Mcllroy S, Bayley JII, Calvert PT. Arthroscopic partial resection of the scapula for snapping scapula: A new technique. J Shoulder Elbow Surg 1999;8(1):53-7. https://doi.org/10.1016/s1058-2746(99)90056-3
29. Trueba Sánchez L, Pérez Carro L, Fernández Escajadillo H. Tratamiento artroscópico de la escápula saltante. Resultados a largo plazo en nuestro medio, descripción de la técnica quirúrgica y revisión de la literatura. Rev Esp Artrosc Cir Articul 2017;24(3). https://doi.org/10.24129/j.reaca.24360.fs1706020
2. Osias W, Matcuk GR Jr, Skalski MR, Patel DB, Schein AJ, Hatch GFR, et al. Scapulothoracic pathology: review of anatomy, pathophysiology, imaging findings, and an approach to management. Skeletal Radiol 2018;47(2):161-71. https://doi.org/10.1007/s00256-017-2791-6
3. de Carvalho SC, Castro A do AE, Rodrigues JC, Cerqueira WS, Santos D do CB, Rosemberg LA. Snapping scapula syndrome: pictorial essay. Radiol Bras 2019;52(4):262-7. https://doi.org/10.1590/0100-3984.2017.0226
4. Frank RM, Ramirez J, Chalmers PN, McCormick FM, Romeo AA. Scapulothoracic anatomy and snapping scapula syndrome. Anat Res Int 2013;2013:635628. https://doi.org/10.1155/2013/635628
5. Gaskill T, Millett PJ. Snapping scapula syndrome: diagnosis and management. J Am Acad Orthop Surg
2013;21(4):214-24. https://doi.org/10.5435/JAAOS-21-04-214
6. Williams CH, Jamal Z, Sternard. BT. Bursitis [Internet]. StatPearls; 2022. Disponible en:
https://www.ncbi.nlm.nih.gov/books/NBK513340/
7. Srikumaran U, Wells JH, Freehill MT, Tan EW, Higgins LD, Warner JJP. Scapular winging: A great masquerader of shoulder disorders: AAOS exhibit selection: AAOS exhibit selection. J Bone Joint Surg Am 2014;96(14):e122. https://doi.org/10.2106/JBJS.M.01031
8. Tepelenis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, et al. Osteochondromas: An updated review of epidemiology, pathogenesis, clinical presentation, radiological features, and treatment options. In Vivo 2021;35(2):681-91. https://doi.org/10.21873/invivo.12308
9. Ngongang FO, Fodjeu G, Fon AC, Fonkoue L, Guifo ML, Bitang A, et al. Surgical treatment of rare case of scapula osteochondroma in a resource limited setting: A case report. Int J Surg Case Rep 2019;61:130-4.
https://doi.org/10.1016/j.ijscr.2019.07.015
10. Kaiser CL, Yeung CM, Raskin K, Gebhardt MC, Anderson ME, Lozano-Calderón SA. Tumors of the scapula: A retrospective analysis identifying predictors of malignancy. Surg Oncol 2020;32:18-22.
https://doi.org/10.1016/j.suronc.2019.10.020
11. Khan Z, Gerrish AM, Grimer RJ. An epidemiological survey of tumour or tumour like conditions in the scapula and periscapular region. SICOT J 2016;2:34. https://doi.org/10.1051/sicotj/2016023
12. Boinet J. Snapping scapula. Bulletin Societe Imperiale Chirurugie 1867;8:458.
13. Song Y, Liu J, Cao L, Yu B-H, Sun T, Shi L, et al. Clinical and imaging features of tumors in the scapula. Curr Med Imaging Rev 2022;18(6):674-83. https://doi.org/10.2174/1573405617666210901144924
14. Park SB, Ramage. JL. Winging of the scapula. StatPearls; 2022. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK541005/
15. Gooding BWT, Geoghegan JM, Wallace WA, Manning PA. Scapular winging. Shoulder Elbow 2014;6(1):4-11. https://doi.org/10.1111/sae.12033
16. Edelson JG. Variations in the anatomy of the scapula with reference to the snapping scapula. Clin Orthop Relat Res 1996;322(322):111-5. https://doi.org/10.1097/00003086-199601000-00013
17. Lehtinen JT, Macy JC, Cassinelli E, Warner JJP. The painful scapulothoracic articulation: Surgical management. Clin Orthop Relat Res 2004;423:99-105. https://doi.org/10.1097/01.blo.0000128647.38363.8e
18. Williams GR, Ramsey ML, Wiesel SW. Técnicas quirúrgicas en hombro y codo. Baltimore, MD: Wolters Kluwer Health; 2011.
19. Lazar MA, Kwon YW, Rokito AS. Snapping scapula syndrome. J Bone Joint Surg Am 2009;91(9):2251-62.
https://doi.org/10.2106/JBJS.H.01347
20. Kuhn JE, Plancher K, Hawkins RJ. Symptomatic scapulothoracic crepitus and bursitis. J Am Acad Orthop Surg 1998;6(5):267-73. https://doi.org/10.5435/00124635-199809000-00001
21. Kuhne M, Boniquit N, Ghodadra N, Romeo AA, Provencher MT. The snapping scapula: diagnosis and treatment. Arthroscopy 2009;25(11):1298-311. https://doi.org/10.1016/j.arthro.2008.12.022
22. Chan BK, Chakrabarti AJ, Bell SN. An alternative portal for scapulothoracic arthroscopy. J Shoulder Elbow Surg 2002;11(3):235-8. https://doi.org/10.1067/mse.2002.121767
23. Millett PJ, Gaskill TR, Horan MP, van der Meijden OA. Technique and outcomes of arthroscopic scapulothoracic bursectomy and partial scapulectomy. Arthroscopy 2012;28(12):1776-83.
https://doi.org/10.1016/j.arthro.2012.05.889
24. Conduah AH, Baker CL 3rd, Baker CL Jr. Clinical management of scapulothoracic bursitis and the snapping scapula. Sports Health 2010;2(2):147-55. https://doi.org/10.1177/1941738109338359
25. Pearse EO, Bruguera J, Massoud SN, Sforza G, Copeland SA, Levy O. Arthroscopic management of the painful snapping scapula. Arthroscopy 2006;22(7):755-61. https://doi.org/10.1016/j.arthro.2006
26. Pavlik A, Ang K, Coghlan J, Bell S. Arthroscopic treatment of painful snapping of the scapula by using a new superior portal. Arthroscopy 2003;19(6):608-12. https://doi.org/10.1016/s0749-8063(03)00171-3
27. Nicholson GP, Duckworth MA. Scapulothoracic bursectomy for snapping scapula syndrome. J Shoulder Elbow Surg 2002;11(1):80-5. https://doi.org/10.1067/mse.2002.120807
28. Harper GD, Mcllroy S, Bayley JII, Calvert PT. Arthroscopic partial resection of the scapula for snapping scapula: A new technique. J Shoulder Elbow Surg 1999;8(1):53-7. https://doi.org/10.1016/s1058-2746(99)90056-3
29. Trueba Sánchez L, Pérez Carro L, Fernández Escajadillo H. Tratamiento artroscópico de la escápula saltante. Resultados a largo plazo en nuestro medio, descripción de la técnica quirúrgica y revisión de la literatura. Rev Esp Artrosc Cir Articul 2017;24(3). https://doi.org/10.24129/j.reaca.24360.fs1706020