Scapulothoracic Bursitis in a Patient With Quadriparesis

Scapulothoracic bursitis is a rare disease and presents as pain or swelling around the bursa of the scapulothoracic articulation. It has been reported to be related to chronic repetitive mechanical stress of the periscapular tissue, trauma, overuse, and focal muscle weakness. The authors experienced an atypical case of scapulothoracic bursitis with shoulder and periscapular pain after quadriparesis. This case implies that muscular atrophy around the scapula and chest wall from quadriparesis may contribute to the development of scapulothoracic bursitis with shoulder and periscapular pain. In addition, clinician should be alert to it as a possible cause when a patient with quadriparesis complains of shoulder and periscapular pain and consider proper diagnostic options such as ultrasonography or magnetic resonance imaging. (Medicine 94(16):e752) Abbreviation: MRI = magnetic resonance imaging. INTRODUCTION A scapulothoracic bursitis is a rare disease; its pathogenesis is known to be related to chronic repetitive mechanical stress of periscapular tissue, usually resulting from a bone abnormality such as a protrusion of the scapula or rib cage. Conduah et al reported that scapulothoracic bursitis could be caused from an inflammation of the bursa secondary to trauma or overuse owing to sports activities or work. They also reported that focal muscle weakness or atrophy could also play a role in idiopathic cases of scapulothoracic bursitis. Fujikawa et al reported a case of chronic scapulothoracic bursitis after thoracoplasty, and El-Khoury et al reported 2 cases of bursa formation in association with osteochondromas. Individuals with spinal cord injury may experience muscle atrophy because of their reduced metabolic rate and disuse of affected body. Periscapular muscle atrophy is seen in chronic patients with quadriplegia and it may increase friction force ng Hoon Han, MD, PhD knowledge, this is the first report of scapulothoracic bursitis in a patient with quadriparesis and the authors report the case with related literature review. METHOD This is a case report and approval of the ethics committee or institutional review board was not obtained. Informed consent was not obtained from the patient because he was not trackable after discharge.