title: Scapulothoracic bursitis and snapping scapula syndrome: a critical review of current evidence.
abstract: BACKGROUND
  Symptomatic scapulothoracic disorders, such as painful scapular crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients.
  
  
  OBJECTIVE
  To review the current knowledge pertaining to snapping scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  We performed a preliminary search of the PubMed and Embase databases using the search terms "snapping scapula," "scapulothoracic bursitis," "partial scapulectomy," and "superomedial angle resection" in September 2013. All nonreview articles related to the topic of snapping scapula syndrome were included.
  
  
  RESULTS
  The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of evidence obtained from this literature search was inadequate to perform a formal systematic review or meta-analysis. Therefore, a critical review of current evidence is presented.
  
  
  CONCLUSIONS
  Snapping scapula syndrome, a likely underdiagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is typically unknown, specific treatments that are effective for some patients may not be effective for others. Nevertheless, bursectomy with or without partial scapulectomy is currently the most effective primary method of treatment in patients who fail nonoperative therapy. However, many patients experience continued shoulder disability even after surgical intervention. Future studies should focus on identifying the modifiable factors associated with poor outcomes after operative and nonoperative management for snapping scapula syndrome in an effort to improve clinical outcomes and patient satisfaction.
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Warth
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA At the time of this study.
authors.forename: Ulrich J
authors.initials: UJ
authors.lastname: Spiegl
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA drmillett@thesteadmanclinic.com.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
mesh_terms: D002062:Bursitis / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D064169:Intermediate Back Muscles / Q000033:anatomy & histology; D010808:Physical Examination; D012540:Scapula / Q000033:anatomy & histology / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology*; D064171:Superficial Back Muscles / Q000033:anatomy & histology; D013577:Syndrome; D035441:Thoracic Wall / Q000033:anatomy & histology*
keywords: bursitis; crepitus; partial scapulectomy; scapulothoracic; snapping scapula; superomedial angle resection