- 726.10 Disorders of bursae and tendons in shoulder region
- M75.50 Bursitis of unspecified shoulder
- Scapulothoracic joint not a true synovial joint
- 2:1 ratio of glenohumeral (GH) elevation to scapulothoracic
- Scapulothoracic motion produces a snapping, popping, crepitus
- Scapula has the greatest number of muscles attached to it
than any other bone.
- Scapula dysrhythmia can cause friction along the muscles and
- Can be a result of serratus anterior muscle dysfunction
- Injury to long thoracic nerve
- Often asymptomatic
- Winging can help identify a dysfunction possibly occurring
in the shoulder
- Symptoms of pain and weakness
- Can be a result of a brachial plexus injury
- Parsonage-Turner syndrome (brachial neuritis) underlying
- Postural changes of the thoracic spine and ribcage: scoliosis
- Loss of serratus anterior muscle
- Weakness of trapezius strength, scapular stabilizers
- Commonly associated with presence of other orthopedic pathologies
such as subacromial impingement syndrome, rotator cuff pathology,
and labral pathology.
- Creates an abnormal scapulothoracic rhythm
- Commonly associated with repeated overhead or overuse activities
- Full history of symptoms, medical history screening, and differential
shoulder orthopedic examination will ensure appropriate diagnosis.
- Overhead athletes
- Symptoms of bursitis
- Muscle spasm along rib cage
- Weakness is commonly noted with functional reaching tasks
- Scapula instability, moving away from rib cage
- Inability to raise or lower arms without the scapula’s
inferior angle tilting away from rib cage
- Pain/limitation with:
- Overhead activities
- Dressing and grooming
- Sustained or repetitive shoulder activities
- Increased thoracic kyphosis and sub-optimal posture
- Luschka tubercle
- Sprengel’s deformity
- Abnormally shaped rib cage: scoliosis
- Repetitive overhead activities
- Posterior shoulder capsule tightness
- Inferior angle tilting of the scapula
- Instability of the scapula to the thoracic wall
- Muscle atrophy
- Pectoralis minor tightness
- Poor neuromuscular control: nerve injury
- Non-traumatic injury to the long thoracic nerve
- Traumatic injury to the long thoracic nerve
- Impact injury
- Stretch to cervical spine
- Electrical shock
- Mastectomy with axillary node dissection
- Brachial neuritis (Parsonage-Turner syndrome)
- Winging scapula
- Scapula alata
- Facioscapulohumeral muscular dystrophy (FSH)
- Serratus anterior palsy
- Cervical radiculopathy, C5-8
- Referred pain from lungs or diaphragm
- Rotator cuff pathology (tendonitis, full- or partial-thickness
- GH instability
- Labral tear
- Rib fracture
- Internal impingement
- Diagnosis made based on orthopedic special tests, signs
and symptoms, imaging studies, and exclusion of differential diagnosis.
- Push-ups test
- Serratus wall test
- Radiologist for imaging, ...
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