Snapping Scapula Syndrome
Other Names
- Washboard syndrome
- Snapping Scapula Syndrome
Background
- Snapping scapula syndrome is defined as an audible/ palpable clicking of the scapula during movements of the scapulothoracic joint. [1]
History
- Needs to be updated
Epidemiology
- usually noted in young active patients
Introduction
General
- Snapping scapula syndrome is defined as an audible/ palpable clicking of the scapula during movements of the scapulothoracic joint. [2]
- Onset can be insidious, associated with change in physical activity level, or associated with trauma [3]
Pathophysiology
- Scapular snapping is caused by friction or mechanical impingement between the scapula and thoracic wall. [4]
- Contributing factors to impingement or increased friction: [3]
- Morphological alteration of the scapula and rib cage
- Scapular extoses
- Luschka’s tubercle
- Malunion of scapular fractures
- Sprengel’s deformity
- Healing rib fractures
- Scapular extoses
- Scapular dyskinesia
- Alterations in the static scapular position
- Loss of dynamic control of scapular motion
- Thickened bursa
- Bone or soft tissue masses
Anatomy of the Scapula
- Needs to be updated
Risk Factors
- Needs to be updated
Differential Diagnosis
Periscapular Pain
- scapulothoracic bursitis
- scapular dyskinesia
- abnormal scapular morphology
- benign bone or soft tissue neoplasia
- malignancy
Differential Diagnosis Shoulder Pain
- Fractures
- Proximal Humerus Fracture
- Humeral Shaft Fracture
- Clavicle Fracture
- Scapula Fracture
- First Rib Fracture (traumatic or atraumatic)
- Floating Shoulder
- Dislocations & Separations
- Arthropathies
- Muscle & Tendon Injuries
- Rotator Cuff
- Bursopathies
- Ligament Injuries
- Neuropathies
- Other
- Pediatrics
- Coracoid Avulsion Fracture
- Humeral Head Epiphysiolysis (Little League Shoulder)
Clinical Features
History
- Patients often report:
- Pain during rapid shoulder movements or overhead activities
- Pain location supero-medial angle or inferior pole of the scapula
- Audible and palpable crepitus with active shoulder movements [3]
Physical Exam: Physical Exam Shoulder
- Needs to be updated
Special Tests
- Needs to be updated
Evaluation
Radiographs
- Standard Radiographs Shoulder
- Used to screen for osseous abnormalities
- AP, lateral, and axillary views in the plane of the scapula [5]
CT scan
- Used to characterize lesions and bony details
- 3D CT is considered the best imaging modality to delineate potential bony irregularities responsible for scapulothoracic irritation. [5]
Classification
- Not applicable
Management
Nonoperative
- Indicated
- Nearly all cases
- Exception is the presence of an aggressive or malignant lesion
- NSAIDs
- Activity modification
- Steroid injection
- Physical therapy
- Periscapular muscle strengthening
- Postural training [5]
Operative
- Indications
- Malignancy
- Technique
- Open or arthroscopic scapular resection and/or bursectomy [5]
Rehab and Return to Play
Rehabilitation
- Open procedures require a more extensive rehabilitation course compared to arthroscopic procedures due to more muscle disruption.
- Physical therapy begins with passive motion, then active motion and finally strengthening exercises.
Return to Play/ Work
- After arthroscopy, a full recovery is expected by 2 to 4 weeks with return to sports by 2 to 3 months.
- Open procedures have a longer recovery time, often extending beyond 3 months. [6]
Prognosis and Complications
Prognosis
- Needs to be updated
Complications
- Needs to be updated
See Also
References
- ↑ de Carvalho SC, Castro ADAE, Rodrigues JC, Cerqueira WS, Santos DDCB, Rosemberg LA. Snapping scapula syndrome: pictorial essay. Radiol Bras. 2019 Jul-Aug;52(4):262-267. doi: 10.1590/0100-3984.2017.0226. PMID: 31435089; PMCID: PMC6696755.
- ↑ de Carvalho SC, Castro ADAE, Rodrigues JC, Cerqueira WS, Santos DDCB, Rosemberg LA. Snapping scapula syndrome: pictorial essay. Radiol Bras. 2019 Jul-Aug;52(4):262-267. doi: 10.1590/0100-3984.2017.0226. PMID: 31435089; PMCID: PMC6696755.
- ↑ 3.0 3.1 3.2 Merolla G, Cerciello S, Paladini P, Porcellini G. Snapping scapula syndrome: current concepts review in conservative and surgical treatment. Muscles Ligaments Tendons J. 2013 Jul 9;3(2):80-90. doi: 10.11138/mltj/2013.3.2.080. PMID: 23888290; PMCID: PMC3711706.
- ↑ Bell SN, Troupis JM, Miller D, Alta TD, Coghlan JA, Wijeratna MD. Four-dimensional computed tomography scans facilitate preoperative planning in snapping scapula syndrome. J Shoulder Elbow Surg. 2015;24(4):e83-e90. doi:10.1016/j.jse.2014.09.020
- ↑ 5.0 5.1 5.2 5.3 Gaskill T, Millett PJ. Snapping scapula syndrome: diagnosis and management. J Am Acad Orthop Surg. 2013;21(4):214-224. doi:10.5435/JAAOS-21-04-214
- ↑ Kuhne M, Boniquit N, Ghodadra N, Romeo AA, Provencher MT. The snapping scapula: diagnosis and treatment. Arthroscopy. 2009;25(11):1298-1311. doi:10.1016/j.arthro.2008.12.022
Created by:
Elexia Wright on 9 July 2025 14:13:38
Authors:
Last edited:
11 July 2025 01:52:41
Categories: