It is caused by an abnormal lesion or growth that can be found between the rib cage and the scapula. The joint located where the shoulder blade and the scapula normally slide along the chest wall as it moves is the scapulothoracic joint. The bursa is a tiny sac of liquid that is positioned between the two bones. It is filled with synovial fluid that allows the bones to move without scraping and adds a cushion around the joint.
When the bursa gets inflamed due to an accident or injury, this is called bursitis and can be very painful. It may also be caused by age as a side effect of osteoarthritis. There may be scar tissue that can constrict the movement of the fluid. It is likely to hear snapping and grinding sounds when this occurs. It can be very painful and may need extensive testing to diagnose the problem. A fluoroscopic x-ray procedure can be used. CT scans are a good way to diagnose the issue.
Grinding and snapping noise when the shoulder is placed in certain ways is one of the most common causes. The noise is likely heard with pain and it may limit the mobility of the shoulder
Symptoms of this problem include noticing a snapping or grinding noise when moving the shoulder in certain ways. The snapping or crepitus and grinding noises may be accompanied by pain and cause the person to have limited movement and mobility in that shoulder and arm.
There are several different treatment options that can be used. One option is the conservative treatment plan which is used if there is limited mobility but the case is not severe. It can be used if the pain levels are not that high and involve the use of medications that reduce the inflammation. The patient would take oral steroids to help reduce the joint space inflammation.
The second option is a surgical procedure. An arthroscopic procedure can be done to more the lesions or tumors that are causing the pain or limited movement. The bony prominences will be shaved down that may be causing the pain and limited mobility. If the bursa needs to be removed from the joint space, the surgical procedure is called a bursectomy.
A non-invasive choice for the treatment of this condition. Steroids and anesthetic medications are injected into the bursa to relieve the inflammation and pain into the joint space. This treatment allows for a quick and less painful procedure with lasting effects. This is one of the more prominent procedures because it can be done in a small amount of time and it has the least amount of recovery time.
Chang, W. H., Kim, Y. W., Choi, S., & Lee, S. C. (2014). Comparison of the therapeutic effects of intramuscular subscapularis and scapulothoracic bursa injections in patients with scapular pain: a randomized controlled trial. Rheumatology International -Berlin-, 34(9), 1203-1209.
Chang, MD, Won Hyuk, Im, MD, Sang Hee, Ryu, MD,PHD, Jeong Ah,Lee, MD,PHD, Sang Chul, & Kim, MD, Ji Sung. (2009). The effects of Scapulothoracic Bursa Injections in Patients with scapular pain: a pilot study. Retrieved from http://nyulmc-rehab.med.nyu.edu/system/files/u19/scapula_injection_kim.pdf