Scapulothoracic bursitis or the snapping scapula syndrome may mimic with shoulder pain

The scapulothoracic joint plays an important role in overall shoulder function by providing a stable base for glenohumeral rotation. Snapping scapula syndrome, a likely underdiagnosed condition, can produce significant shoulder dysfunction in many patients. Since the precise origin is difficult to understand, it may sometimes mimic shoulder pain. Any dysfunction of the muscles, ligaments, and bursa may cause abnormal scapular motion and predispose to scapulothoracic joint disorders. Accurate recognition of the syndrome may lead to prompt and long-term relief of symptoms by conservative/noninvasive or interventional management. The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, bony abnormalities, muscle microtrauma or atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses. However, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be conservative. Interventional procedures are best for treating modalities for scapulothoracic dysfunction, most reports have demonstrated good to excellent outcomes in a significantly high percentage of patients. Clearly, the best initial approach to these conditions is a conservative treatment like nonsteroidal anti-inflammatory drugs along with a plan that combines scapular strengthening, postural re-education, and core strength endurance. If an appropriate trial of nonoperative management proves unsuccessful, local interventions can produce good results.