Acute Exostosis Bursata: A Rare Complication of Scapular Osteochondromas— Case Report and Literature Review
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Published:
Aug 29, 2025
Keywords:
Exostosis bursata, scapular osteochondroma, bursitis, bone tumor
Main Article Content
Abstract
Osteochondromas involve the scapula in only about 4% of cases. Although many are asymptomatic, they may produce symptoms and complications such as pain, crepitus, palpable masses, scapular dyskinesia, snapping scapula, scapular winging, and the formation of large bursae. This latter complication—which can occur at any skeletal site—is referred to as exostosis bursata, a large bursa that typically develops slowly and progressively and may prompt consideration of malignant transformation or infection in the differential diagnosis. We report a rare case of the acute, post-traumatic onset of exostosis bursata secondary to an osteochondroma on the ventral surface of the scapula. The treatment is described, and a review of the literature is provided.
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How to Cite
Moya, D., Salamone, H., Vaccarelli, A., Márquez Grand, D., Alfano, F., & Gómez, D. (2025). Acute Exostosis Bursata: A Rare Complication of Scapular Osteochondromas— Case Report and Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 90(4), 361-368. https://doi.org/10.15417/issn.1852-7434.2025.90.4.1963
Section
Case Presentations
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References
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2. Das R, Arya S, Krishna A, Ghosh S, Mukartihal R, Keezhadath S. Osteochondroma of dorsal scapula: A case report and review of literatura. J Orthop Case Rep 2023;13(7):104-9. https://doi.org/10.13107/jocr.2023.v13.i07.3772
3. Orlow LW. Die exostosis bursata und ihreentstehung. Dtsch Z Chir 1891;31:293-308. Disponible en:
https://link.springer.com/article/10.1007/BF02793491
4. Bell J. A case of exostosis bursata. Ann Surg 1889;9(2):112-5. https://doi.org/10.1097/00000658-188901000-00028
5. McWilliams CA. Subscapular exostosis with adventitious bursa. JAMA 1914;63(17):1473-4.
https://doi.org/10.1001/jama.1914.02570170041010
6. Mohsen MS, Moosa NK, Kumar P. Osteochondroma of the scapula associated with winging and large bursa formation. Med Princ Pract 2006;15:387-90. https://doi.org/10.1159/000094275
7. El-Khoury GY, Bassett GS. Symptomatic bursa formation with osteochondromas. AJR Am J Roentgenol
1979;133(5):895-8. https://doi.org/10.2214/ajr.133.5.895
8. Borges AM, Huvos AG, Smith J. Bursa formation and synovial chondrometaplasia associated with osteochondromas. Am J Clin Pathol 1981;75(5):648-53. https://doi.org/10.1093/ajcp/75.5.648
9. Chiarelli GM, Massan L, Grandi E, Lupi L, Bighi S, Limone GL. Degenerazione borsitica del muscolo gran dentato in esostosi solitaria della scapola. Chir Org Mov 1988;72(4):371-4. PMID: 3447827
10. Griffiths HJ, Thompson RC Jr, Galloway HR, Everson LI, Suh JS. Bursitis in association with solitary
osteochondromas presenting as mass lesions. Skeletal Radiol 1991;20(7):513-6. https://doi.org/10.1007/BF00194249
11. Cuomo F, Blank K, Zuckerman JD, Present DA. Scapular osteochondroma presenting with exostosrs bursata. Bull Hosp Jt Dis 1993,52(2):55-8. PMID: 8443559
12. Ben Hamouda M, Allegue M, Bergaour N, Dahmene J, Korbi S, Moula T, et al. Exostose scapularre compliquee de bursite. J Radiol 1993;74(3):143-6. PMID: 8496842
13. Jacobi CA, Gellert K, Zieren J. Rapid development of subscapular exostosis bursata. J Shoulder Elbow Surg 1997;6(2):164-6. https://doi.org/10.1016/s1058-2746(97)90039-2
14. Okada K, Terada K, Sashi R, Hoshi N. Large bursa formation associated with osteochondroma of the scapula: a case report and review of the literature. Jpn J Clin Oncol 1999;29(7):356-60. https://doi.org/10.1093/jjco/29.7.356
15. Shackcloth MJ, Page RD. Scapular osteochondroma with reactive bursitis presenting as a chest wall tumour. Eur J Cardiothorac Surg 2000;18(4):495-6. https://doi.org/10.1016/s1010-7940(00)00545-5
16. Chávez BA, Giménez Bascuñana A. Exóstosis bursata. XXIV Reunión Anual de la Sociedad Española de Anatomía Patológica. Disponible en: http://www.conganat.org/seap/reuniones/2001/osteoblanda.htm
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18. Yoo WH, Kim JR, Jang KY, Lee SY, Park JH. Rapidly developed huge bursitis associated with scapular
osteochondroma of the multiple exostosis: a case report. Rheumatol Int 2009;29(3):317-9. https://doi.org/10.1007/s00296-008-0659-8
19. Aalderink K, Wolf B. Scapular osteochondroma treated with arthroscopic excision using prone positioning. Am J Orthop (Belle Mead NJ) 2010;39(2):E11-4. PMID: 20396684
20. Frost NL, Parada SA, Manoso MW, Arrington E, Benfanti P. Scapular osteochondromas treated with surgical excision. Orthopedics 2010;33(11):804. https://doi.org/10.3928/01477447-20100924-09
21. Orth P, Anagnostakos K, Fritsch E, Kohn D, Madry H. Static winging of the scapula caused by osteochondroma in adults: a case series. J Med Case Rep 2012;6:363. https://doi.org/10.1186/1752-1947-6-363
22. Ceberut K, Korkmaz M, Ergin I, Müslehiddinoglu A. Bursa formation with scapular osteochondroma in hereditary multiple exostosis. J Coll Physicians Surg Pak 2013;23(7):512-4. PMID: 23823961
23. Sivananda P, Rao BK, Kumar PV, Ram GS. Osteochondroma of the ventral scapula causing scapular static winging and secondary rib erosion. J Clin Diagn Res 2014;8(5):LD03-5. https://doi.org/10.7860/JCDR/2014/8129.4335
24. Flugstad NA, Sanger JR, Hackbarth DA. Pseudo-winging of the scapula caused by scapular osteochondroma: review of literature and case report. Hand (NY) 2015;10(2):353-6. https://doi.org/10.1007/s11552-014-9659-1
25. Ali AA, Sharma P, Rege R, Seena CR, Rajesh S. Exostosis bursata - Multimodality imaging approach. J Clin Diagn Res 2016;10(9):TD03-TD04. https://doi.org/10.7860/JCDR/2016/15688.8431
26. Ogawa K, Inokuchi W. Solitary osteochondroma of the ventral scapula associated with large bursa formation and pseudowinging of the scapula: A case report and literature review. Case Rep Orthop 2018;2018:5145642. https://doi.org/10.1155/2018/5145642
27. Tuncer K, Pirimoglu B, Ogul H. Huge bursitis associated with scapular osteochondroma presenting as a giant mass of the chest wall: A case presentation. PM R 2018;10(12):1431-33. https://doi.org/10.1016/j.pmrj.2018.02.019
28. de Oliveira MA, Alfaro Y, Kotzias Neto A, Korman MC. Subscapular osteochondroma as a differential diagnosis of winged scapula. Rev Bras Ortop (Sao Paulo) 2019;54(03):241-6. https://doi.org/10.1055/s-0039-1692432
29. Ahmed AR, Tan TS, Unni KK, Collins MS, Wenger DE, Sim FH. Secondary chondrosarcoma in osteochondroma: report of 107 patients. Clin Orthop Relat Res 2003;411:193-206.
https://doi.org/10.1097/01.blo.0000069888.31220.2b
30. Moya D. The power of case reports. Journal of Regenerative Science 2024;4(1):01-02. https://doi.org/10.13107/jrs.2024.v04.i01.117
2. Das R, Arya S, Krishna A, Ghosh S, Mukartihal R, Keezhadath S. Osteochondroma of dorsal scapula: A case report and review of literatura. J Orthop Case Rep 2023;13(7):104-9. https://doi.org/10.13107/jocr.2023.v13.i07.3772
3. Orlow LW. Die exostosis bursata und ihreentstehung. Dtsch Z Chir 1891;31:293-308. Disponible en:
https://link.springer.com/article/10.1007/BF02793491
4. Bell J. A case of exostosis bursata. Ann Surg 1889;9(2):112-5. https://doi.org/10.1097/00000658-188901000-00028
5. McWilliams CA. Subscapular exostosis with adventitious bursa. JAMA 1914;63(17):1473-4.
https://doi.org/10.1001/jama.1914.02570170041010
6. Mohsen MS, Moosa NK, Kumar P. Osteochondroma of the scapula associated with winging and large bursa formation. Med Princ Pract 2006;15:387-90. https://doi.org/10.1159/000094275
7. El-Khoury GY, Bassett GS. Symptomatic bursa formation with osteochondromas. AJR Am J Roentgenol
1979;133(5):895-8. https://doi.org/10.2214/ajr.133.5.895
8. Borges AM, Huvos AG, Smith J. Bursa formation and synovial chondrometaplasia associated with osteochondromas. Am J Clin Pathol 1981;75(5):648-53. https://doi.org/10.1093/ajcp/75.5.648
9. Chiarelli GM, Massan L, Grandi E, Lupi L, Bighi S, Limone GL. Degenerazione borsitica del muscolo gran dentato in esostosi solitaria della scapola. Chir Org Mov 1988;72(4):371-4. PMID: 3447827
10. Griffiths HJ, Thompson RC Jr, Galloway HR, Everson LI, Suh JS. Bursitis in association with solitary
osteochondromas presenting as mass lesions. Skeletal Radiol 1991;20(7):513-6. https://doi.org/10.1007/BF00194249
11. Cuomo F, Blank K, Zuckerman JD, Present DA. Scapular osteochondroma presenting with exostosrs bursata. Bull Hosp Jt Dis 1993,52(2):55-8. PMID: 8443559
12. Ben Hamouda M, Allegue M, Bergaour N, Dahmene J, Korbi S, Moula T, et al. Exostose scapularre compliquee de bursite. J Radiol 1993;74(3):143-6. PMID: 8496842
13. Jacobi CA, Gellert K, Zieren J. Rapid development of subscapular exostosis bursata. J Shoulder Elbow Surg 1997;6(2):164-6. https://doi.org/10.1016/s1058-2746(97)90039-2
14. Okada K, Terada K, Sashi R, Hoshi N. Large bursa formation associated with osteochondroma of the scapula: a case report and review of the literature. Jpn J Clin Oncol 1999;29(7):356-60. https://doi.org/10.1093/jjco/29.7.356
15. Shackcloth MJ, Page RD. Scapular osteochondroma with reactive bursitis presenting as a chest wall tumour. Eur J Cardiothorac Surg 2000;18(4):495-6. https://doi.org/10.1016/s1010-7940(00)00545-5
16. Chávez BA, Giménez Bascuñana A. Exóstosis bursata. XXIV Reunión Anual de la Sociedad Española de Anatomía Patológica. Disponible en: http://www.conganat.org/seap/reuniones/2001/osteoblanda.htm
17. Rahul P, Ravikumar Tv, Amit Grover, Sudarshan K. Solitary osteochondroma of the scapula: a rare case report. Int J Med 2014;2(2): Disponible en: https://www.researchgate.net/publication/267748137_Solitary_osteochondroma_of_the_scapula_a_rare_case_report
18. Yoo WH, Kim JR, Jang KY, Lee SY, Park JH. Rapidly developed huge bursitis associated with scapular
osteochondroma of the multiple exostosis: a case report. Rheumatol Int 2009;29(3):317-9. https://doi.org/10.1007/s00296-008-0659-8
19. Aalderink K, Wolf B. Scapular osteochondroma treated with arthroscopic excision using prone positioning. Am J Orthop (Belle Mead NJ) 2010;39(2):E11-4. PMID: 20396684
20. Frost NL, Parada SA, Manoso MW, Arrington E, Benfanti P. Scapular osteochondromas treated with surgical excision. Orthopedics 2010;33(11):804. https://doi.org/10.3928/01477447-20100924-09
21. Orth P, Anagnostakos K, Fritsch E, Kohn D, Madry H. Static winging of the scapula caused by osteochondroma in adults: a case series. J Med Case Rep 2012;6:363. https://doi.org/10.1186/1752-1947-6-363
22. Ceberut K, Korkmaz M, Ergin I, Müslehiddinoglu A. Bursa formation with scapular osteochondroma in hereditary multiple exostosis. J Coll Physicians Surg Pak 2013;23(7):512-4. PMID: 23823961
23. Sivananda P, Rao BK, Kumar PV, Ram GS. Osteochondroma of the ventral scapula causing scapular static winging and secondary rib erosion. J Clin Diagn Res 2014;8(5):LD03-5. https://doi.org/10.7860/JCDR/2014/8129.4335
24. Flugstad NA, Sanger JR, Hackbarth DA. Pseudo-winging of the scapula caused by scapular osteochondroma: review of literature and case report. Hand (NY) 2015;10(2):353-6. https://doi.org/10.1007/s11552-014-9659-1
25. Ali AA, Sharma P, Rege R, Seena CR, Rajesh S. Exostosis bursata - Multimodality imaging approach. J Clin Diagn Res 2016;10(9):TD03-TD04. https://doi.org/10.7860/JCDR/2016/15688.8431
26. Ogawa K, Inokuchi W. Solitary osteochondroma of the ventral scapula associated with large bursa formation and pseudowinging of the scapula: A case report and literature review. Case Rep Orthop 2018;2018:5145642. https://doi.org/10.1155/2018/5145642
27. Tuncer K, Pirimoglu B, Ogul H. Huge bursitis associated with scapular osteochondroma presenting as a giant mass of the chest wall: A case presentation. PM R 2018;10(12):1431-33. https://doi.org/10.1016/j.pmrj.2018.02.019
28. de Oliveira MA, Alfaro Y, Kotzias Neto A, Korman MC. Subscapular osteochondroma as a differential diagnosis of winged scapula. Rev Bras Ortop (Sao Paulo) 2019;54(03):241-6. https://doi.org/10.1055/s-0039-1692432
29. Ahmed AR, Tan TS, Unni KK, Collins MS, Wenger DE, Sim FH. Secondary chondrosarcoma in osteochondroma: report of 107 patients. Clin Orthop Relat Res 2003;411:193-206.
https://doi.org/10.1097/01.blo.0000069888.31220.2b
30. Moya D. The power of case reports. Journal of Regenerative Science 2024;4(1):01-02. https://doi.org/10.13107/jrs.2024.v04.i01.117