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Scapulothoracic bursectomy

44 citationsUpdated Oct 2026
Illustration: shoulder

For patients: a plain-language version of this topic is available. See the patient guide.

Overview

Snapping scapula syndrome arises from osseous lesions or scapulothoracic bursitis, a condition that can be difficult to recognize and treat [1]. Nonoperative management remains the best initial approach for symptomatic scapulothoracic crepitus [7], with extracorporeal shock wave therapy strongly recommended for painful cases of scapulothoracic bursitis [15]. Surgical intervention is indicated when a prolonged trial of conservative therapy is ineffective [11]. Operative options include open scapulothoracic bursectomy, which allows evaluation and treatment of all areas of potential pathology [2], and arthroscopic techniques. Arthroscopic access to the scapulothoracic space is simple and reproducible, with bursal tissue clearance optimizing visualization [9]. Arthroscopic management typically involves scapulothoracic bursectomy and superomedial partial scapulectomy, a technique refined over nearly two decades of experience [6]. In patients whose pain and clicking are clinically localized and who have failed conservative measures, arthroscopic resection of the superomedial corner of the scapula is a useful technique [19]. Pectoralis minor release is beneficial in the treatment of snapping scapular syndrome because arthroscopic scapulothoracic bursectomy and partial scapulectomy alone can result in residual scapular dyskinesis due to pectoralis minor tightness [21].

Both arthroscopic soft-tissue-only debridement and arthroscopic superior medial angle bony resection are effective and acceptable treatments for scapulothoracic bursitis with similar outcomes in regards to shoulder function, pain, reoperation, and patient satisfaction [8]. Similarly, both arthroscopic scapulothoracic bursectomy alone and bursectomy with scapuloplasty are effective treatments for scapulothoracic bursitis with similar outcomes regarding shoulder function, pain, surgical complications, and rates of subsequent shoulder surgery [3]. Scapulothoracic bursectomy with partial scapulectomy is a reliable treatment for scapulothoracic bursitis with predictably high rates of patient satisfaction [4]. Although significant pain and functional improvement can be expected after arthroscopic bursectomy and scapuloplasty, the average postoperative ASES and SANE scores remain lower than expected [5]. Arthroscopic scapulothoracic treatment provides good pain relief and functional improvement for scapulothoracic syndrome in patients who have failed to respond to nonoperative treatment modalities [10]. Arthroscopic bursoscopy and bursectomy is an effective surgical procedure in recalcitrant scapulothoracic bursitis with failed conservative management [13]. Patients undergoing arthroscopic bursectomy and partial scapulectomy for snapping scapula syndrome experienced clinically significant improvements in functional scores, pain, and quality of life, which were sustained at a minimum of 5 years and a mean follow-up of 8.9 years postoperatively [16]. Arthroscopic scapular debridement and resection provided satisfactory midterm clinical outcomes for the treatment of scapulothoracic bursitis [17]. Arthroscopic treatment of scapulothoracic bursitis is a safe, reliable technique that is effective in providing symptomatic relief with a low rate of recurrence, with most patients reporting a significant reduction in periscapular pain [20]. Arthroscopic resection of the medial superior hook formation in combination with partial bursectomy provided good results with significant gains with respect to the WORC score in 90% of the patients troubled by painful snapping scapula for a long time and without relief by exercise-based rehabilitation [22]. Complications of endoscopic bursitis and partial scapular resection include pneumothorax, neurovascular injury, or incomplete resection [24].

Anatomy & Pathophysiology

Scapulothoracic Articulation & Biomechanics

The scapulothoracic articulation glides upon muscular layers rather than cartilaginous surfaces and is described as perhaps the most incongruent articulation in the human body [18]. The scapula has no true bony attachment to the axial skeleton, and its stability is provided by surrounding musculature [31]. The scapula is suspended by muscles alone and serves as a base or platform to facilitate arm movement [54]. It is separated from the chest wall by thin gliding fibro-fatty tissue, allowing smooth excursion over the chest wall [46]. The scapulothoracic joint lacks a synovial lining or cartilaginous interface at its articulation [34]. The anterior scapula glides over the convex thoracic wall with bursal and soft-tissue planes interposed between the bony surfaces [34].

At rest, the scapula is rotated anteriorly approximately 30° relative to the trunk and tilted forward about 20° in the sagittal plane [31]. The scapula is anteverted on the chest wall approximately 30 degrees relative to the body [58]. During arm elevation to 90°, there is approximately a 2:1 ratio of glenohumeral to scapulothoracic motion [31].

Bursae & Soft Tissue

The presence of bursal tissue in the scapulothoracic articulation is physiologic and necessary to facilitate normal motion [18]. Two major (anatomic) bursae and four minor (adventitial) bursae have been described in the scapulothoracic articulation [31]. The infraserratus bursa is located between the serratus anterior muscle and the chest wall [31]. The supraserratus bursa is one of the two major bursae described in the scapulothoracic articulation [31].

Pathophysiology & Etiology

Scapulothoracic syndromes are dynamic disorders resulting from predisposing abnormal anatomy combined with sufficient scapulothoracic motion [18]. Symptoms may be experienced with minimal activity if considerable bony abnormality is present [18]. Repetitive overuse may incite symptoms even in the presence of normal anatomy [18]. Scapulothoracic bursitis is thought to be the result of inflammation caused by overuse of the shoulder girdle [18]. Chronic inflammatory irritation can lead to fibrosis of the affected bursa [18]. Fibrosis may lead to recalcitrant bursitis or snapping even in the absence of overt scapular masses or muscular abnormalities [18]. Overt scapular snapping is frequently the result of bony or soft tissue masses within the scapulothoracic articulation [18]. Mechanical causes of crepitus include fibrotic or anomalous musculature and malunion of scapular structures [18]. Crepitus associated with symptomatic bursitis may be physiologic [23].

Alterations in the normal anatomy or kinematics of the scapula, chest wall, or surrounding tissues can result in pathologic irritation of the subscapular bursa or fibrosis [34]. Anterior angulation of the medial scapula in the axial plane is associated with snapping scapula syndrome [38]. Patients with a concave-shaped scapula and a positive medial superior corner angle may be at risk for snapping scapula syndrome [75].

Etiology of Snapping Scapula Syndrome: Scapulothoracic bursitis was the most common etiology of snapping scapula syndrome, occurring in 89.2% of shoulders in a systematic review [29]. Bony prominence of the superomedial angle of the scapula was the second most common etiology, occurring in 86.2% of shoulders [29]. 78.3% of shoulders with snapping scapula syndrome had a mixed etiology, most frequently concurrent bursitis and bony prominence [29].

Classification

Aetiological Spectrum: Snapping scapula is a controversial condition attributed to bony and soft tissue abnormalities [23]. It is not uncommon for snapping scapula to present clinically without any form of crepitus or craquement [23]. A spectrum of mechanical causes results in crepitus, including fibrotic or anomalous musculature and malunion of scapular structures [18]. Fibrosis of the affected bursa may occur if sufficient irritation creates a chronic inflammatory environment [18].

Systematic Review Data: The most common aetiology of snapping scapula syndrome is scapulothoracic bursitis, affecting 181 shoulders (89.2%) in a systematic review [29]. The second most common aetiology is bony prominence of the superomedial angle of the scapula, affecting 175 shoulders (86.2%) [29]. Osteochondroma was identified as the aetiology in 6 shoulders (3.0%) [29]. Bursal and scar tissue at the scapular insertion site from a rhomboids major muscle avulsion was identified as the aetiology in 1 shoulder (0.5%) [29].

Mixed Aetiology: 78.3% of shoulders had a mixed aetiology for snapping scapula syndrome [29]. Scapulothoracic bursitis and bony prominence of the superomedial angle of the scapula occurred concurrently most frequently, affecting 158 shoulders (77.8%) [29].

Clinical Presentation

Pathophysiology and Etiology

Bursal tissue is physiologic and necessary to facilitate normal scapulothoracic motion [18]. Repetitive overuse may incite symptoms even in the presence of normal anatomy, resulting in a spectrum of severity ranging from mild soreness to debilitating crepitus [18]. Chronic inflammatory environments can lead to fibrosis of the affected bursa, which may ultimately lead to recalcitrant bursitis or snapping even in the absence of overt scapular masses or muscular abnormalities [18]. Overt scapular snapping is frequently the result of bony or soft tissue masses within the scapulothoracic articulation and may coexist with scapulothoracic bursitis [18]. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis [1].

The most common aetiologies of snapping scapula syndrome are scapulothoracic bursitis (89.2%) and bony prominence of the superomedial angle of the scapula (86.2%) [29]. Osteochondroma is a less common aetiology, accounting for 3.0% of cases [29]. Bursal and scar tissue at the scapular insertion site from a rhomboids major muscle avulsion is a rare aetiology, accounting for 0.5% of cases [29]. A mixed aetiology was present in 78.3% of shoulders with snapping scapula syndrome, with scapulothoracic bursitis and bony prominence of the superomedial angle occurring concurrently most frequently (77.8%) [29].

Clinical Features and Diagnosis

The snapping scapula syndrome can be difficult to recognize and treat [1]. High clinical suspicion is necessary in patients presenting with medial scapular border tenderness, palpable crepitus, and audible snapping [35]. Focused history and physical examination are essential initial steps toward the diagnosis [35]. Supplemental imaging is used to assess structural etiologies when nonoperative management fails [35]. Crepitus associated with symptomatic bursitis may be physiologic, and it is not uncommon for the clinical presentation to occur without any form of crepitus or craquement [23].

Investigations

Plain radiography: Standardized plain films are almost always sufficient to garner the information needed for shoulder evaluation [42]. The standard shoulder series should include orthogonal views of the shoulder, including a true AP view in the scapular plane, an AP view, an axillary view, and a scapular Y view [69]. The scapular Y view can show scapular body abnormalities such as osteochondroma or fracture [69].

MRI: MRI is the modality of choice for evaluating the rotator cuff, biceps, and subacromial/subdeltoid bursa [68]. It is useful to identify osteonecrosis of the humeral head, or a bone tumour [61]. MRI can identify labral tears and rotator cuff tears, although the accuracy for these is enhanced by combining the scan with arthrography [61]. In the context of scapulothoracic bursitis, assessment of novel bony parameters on Magnetic Resonance Imaging has been utilized alongside arthroscopic debridement and resection [17].

CT: CT imaging is frequently used to evaluate fractures of the shoulder, to assess for bony lesions in recurrent instability cases, or for preoperative templating for shoulder arthritis [68]. CT is helpful for planning fracture surgery and shoulder joint replacement [61]. CT with three-dimensional reconstructions is the advanced imaging study of choice for determining the extent of glenoid bone loss in the setting of shoulder instability [69]. Postoperative 3D-CT of the scapula can demonstrate a complete resection of the curved area of the superior angle [39].

Ultrasonography: Ultrasonography is a low-cost alternative to MRI and arthrography for evaluating both skeletal and soft-tissue structures of the shoulder [68]. It is a simple and accurate test for identifying rotator cuff tears and calcific tendinitis [61]. Ultrasonography can provide immediate, real-time visualization of the rotator cuff, biceps tendon, and calcific deposits [68]. It can be useful in guiding injections or barbotage [61]. However, ultrasonography is highly operator dependent and is not as useful for evaluating labral tears or rotator cuff tears that are very small or larger than 3 cm [68].

Arthroscopy: Arthroscopy is useful for diagnosing and treating subacromial impingement, intra-articular lesions, detachment of the glenoid labrum and rotator cuff tears [61]. Visualization and resection of the superior angle of the scapula are technically easier using an additional superior portal [30].

Other Considerations: The purpose of imaging of the shoulder is to help establish the diagnosis, determine the severity of the pathoanatomy, assist in surgical planning, and enable the surgeon to illustrate the condition of the shoulder to the patient [42]. The temptation to “overimage” should be resisted, obtaining only the scans or reconstructions that are necessary for the care of the patient [42]. Anterior angulation of the medial scapula in the axial plane was associated with snapping scapula syndrome [38]. The anterior offset of the scapula appeared to be the most important bony parameter to consider during preoperative planning and the evaluation of scapulothoracic space decompression with partial scapulectomy [25]. Study results provide a large safe zone that can maximize the amount of bone that can be resected confidently from the superomedial corner of the scapula [40].

Treatment

Non-Operative

Nonoperative management is curative in most cases and should be initiated for 3 to 6 months before considering surgical intervention [35]. Initial treatment typically includes physical therapy for scapular muscle strengthening, nonsteroidal anti-inflammatory medications, and activity modification [26, 34]. Corticosteroid injections serve as both a diagnostic and therapeutic modality [34]. Systematic reviews identify several non-operative treatment types, including extracorporeal shock wave therapy, a single local injection of 80mg of methylprednisolone, ultrasound-guided triamcinolone scapulothoracic bursal injection, non-ultrasound guided triamcinolone scapulothoracic bursal injection, and steroid and hyaluronate scapulothoracic bursa injection administered once weekly for 3 weeks [33]. Extracorporeal shock wave therapy is a beneficial and trustable method that can be strongly recommended in painful cases of scapulothoracic bursitis [15].

Operative

Indications: Surgical resection of the superomedial angle or the medial border of the scapula is advocated when a prolonged trial of conservative therapy is ineffective [11]. Arthroscopic scapuloplasty leads to significant improvement in pain and function in patients with snapping scapula syndrome refractory to conservative treatment [28].

Surgical Approach / Technique: A step-by-step technique using standard anatomic landmarks and a measured resection approach provides a methodical method for safety, reproducibility, and optimization of scapulothoracic endoscopy [36]. A technique for arthroscopic management that includes scapulothoracic bursectomy and superomedial partial scapulectomy has been refined over nearly two decades of experience [6]. When specific steps are followed, a full-house arthroscopic technique including bursectomy, levator scapulae release, and partial scapulectomy provides a reproducible and minimally invasive solution for snapping scapula syndrome [27].

Other Considerations: Pectoralis minor release is beneficial in the treatment of snapping scapula syndrome because arthroscopic scapulothoracic bursectomy and partial scapulectomy alone can result in residual scapular dyskinesis due to pectoralis minor tightness [21].

Complications

Pneumothorax: Pneumothorax is a recognized complication of endoscopic bursitis and partial scapular resection [24].

Neurovascular Injury: Neurovascular injury is a reported complication of endoscopic bursitis and partial scapular resection [24].

Incomplete Resection: Incomplete resection is a potential complication of endoscopic bursitis and partial scapular resection [24].

Residual Scapular Dyskinesis: Arthroscopic scapulothoracic bursectomy and partial scapulectomy alone can result in residual scapular dyskinesis because of pectoralis minor tightness [21].

Other Considerations: Arthroscopic scapulothoracic bursectomy alone and bursectomy with scapuloplasty have similar outcomes regarding surgical complications [3]. Arthroscopic soft-tissue-only debridement and arthroscopic superior medial angle bony resection have similar outcomes regarding reoperation [8]. Arthroscopic treatment of scapulothoracic bursitis is associated with a low rate of recurrence [20]. A high rate of residual symptoms has been reported following arthroscopic management of snapping scapula syndrome [29]. The average postoperative ASES and SANE scores remain lower than expected after arthroscopic bursectomy and scapuloplasty [5].

Recovery

Other Considerations: The available evidence for this section does not specify distinct recovery phases, rehabilitation protocols, or functional milestones for scapulothoracic bursectomy. A "full-house" arthroscopic technique involving bursectomy, levator scapulae release, and partial scapulectomy provides a reproducible and minimally invasive solution for snapping scapula syndrome [27].

Key Evidence

  • [L5] The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. [1] (10.1155/2013/635628)
  • [L4] Open scapulothoracic bursectomy allowed evaluation and treatment of all areas of potential pathology. [2] (10.1067/mse.2002.120807)
  • [L3] Both arthroscopic scapulothoracic bursectomy alone and bursectomy with scapuloplasty are effective treatments for scapulothoracic bursitis with similar outcomes regarding shoulder function, pain, surgical complications, and rates of subsequent shoulder surgery. [3] (10.1016/j.jse.2023.03.020)
  • [L4] Scapulothoracic bursectomy with partial scapulectomy is a reliable treatment for scapulothoracic bursitis with predictably high rates of patient satisfaction. [4] (10.1177/2325967113505739)
  • [L4] Although significant pain and functional improvement can be expected after arthroscopic bursectomy and scapuloplasty, the average postoperative ASES and SANE scores remain lower than expected. [5] (10.1016/j.arthro.2012.05.889)
  • [L5] This Technical Note presents a technique for arthroscopic management of snapping scapula syndrome that includes scapulothoracic bursectomy and superomedial partial scapulectomy, which has been refined over nearly two decades of experience. [6] (10.1016/j.eats.2022.02.028)
  • [L4] Nonoperative treatment is the best approach for patients with symptomatic scapulothoracic crepitus. [7] (10.5435/00124635-199809000-00001)
  • [L3] Both arthroscopic soft-tissue-only debridement and arthroscopic superior medial angle bony resection are effective and acceptable treatments for scapulothoracic bursitis with similar outcomes in regards to shoulder function, pain, reoperation, and patient satisfaction. [8] (10.1177/2325967121s00695)
  • [Paper] Arthroscopic access to the scapulothoracic space is simple and reproducible, with bursal tissue clearance optimizing visualization. [9] (10.1016/j.eats.2015.07.002)
  • [L4] Based on the results, the study concludes that arthroscopic scapulothoracic treatment provides good pain relief and functional improvement for scapulothoracic syndrome in patients who have failed to respond to nonoperative treatment modalities. [10] (10.2174/1874325001711010785)
  • [L4] When prolonged trial of conservative therapy is ineffective, surgical resection of the superomedial angle or the medial border of the scapula is advocated. [11] (10.1016/s1058-2746(96)80466-6)
  • [L4] Arthroscopic bursoscopy and bursectomy is an effective surgical procedure in recalcitrant scapulothoracic bursitis with failed conservative management. [13] (10.13107/jocr.2025.v15.i02.5290)
  • [L1] We believe that ESWT is a beneficial and trustable method of treatment and can be strongly recommended in painful cases of scapulothoracic bursitis. [15] (10.1177/2309499016684723)
  • [L4] Patients undergoing arthroscopic bursectomy and partial scapulectomy for SSS experienced clinically significant improvements in functional scores, pain, and quality of life, which were sustained at a minimum of 5 years and a mean follow-up of 8.9 years postoperatively. [16] (10.1177/03635465241243072)
  • [L4] Arthroscopic scapular debridement and resection provided satisfactory midterm clinical outcomes for the treatment of scapulothoracic bursitis. [17] (10.1177/2325967121998273)
  • [L5] [18] (10.5435/jaaos-21-04-214)
  • [L4] Arthroscopic resection of the superomedial corner of the scapula is a useful technique in patients whose pain and clicking can be clinically localized and who have failed to respond to conservative measures. [19] (10.1016/s1058-2746(99)90056-3)
  • [L4] Arthroscopic treatment of scapulothoracic bursitis is a safe, reliable technique that is effective in providing symptomatic relief with a low rate of recurrence, with most patients reporting a significant reduction in periscapular pain. [20] (10.1016/j.jseint.2022.08.002)
  • [L5] In the treatment of these patients, PM release is beneficial because arthroscopic scapulothoracic bursectomy and partial scapulectomy alone can result in residual scapular dyskinesis because of PM tightness. [21] (10.1016/j.eats.2023.02.015)
  • [L4] In this study, it was found that arthroscopic resection of the medial superior hook formation in combination with partial bursectomy provided good results with significant gains with respect to the WORC score in 90 % of the patients troubled by painful snapping scapula for a long time and without relief by exercise-based rehabilitation. [22] (10.1007/s00590-012-1154-1)
  • [L5] [23] (10.11138/mltj/2013.3.2.080)
  • [L5] Complications of endoscopic bursitis and partial scapular resection include pneumothorax, neurovascular injury, or incomplete resection. [24] (10.1097/bte.0b013e31802c9f31)
  • [L5] The anterior offset of the scapula appeared to be the most important bony parameter to consider during preoperative planning and the evaluation of scapulothoracic space decompression with partial scapulectomy. [25] (10.1177/0363546516687755)
  • [L5] In most cases, nonoperative treatment is curative and includes physical therapy for scapular muscle strengthening and nonsteroidal anti-inflammatory medications. [26] (10.1016/j.arthro.2008.12.022)
  • [L5] When these steps are followed, this technique provides a reproducible and minimally invasive solution for snapping scapula syndrome. [27] (10.1016/j.eats.2025.103671)
  • [L3] Arthroscopic scapuloplasty leads to significant improvement in pain and function in patients with snapping scapula syndrome refractory to conservative treatment. [28] (10.1016/j.arthro.2020.07.024)
  • [L1] [29] (10.1007/s00167-017-4693-5)
  • [L5] Visualization and resection of the superior angle of the scapula are technically easier using an additional superior portal. [30] (10.1067/mse.2002.121767)
  • [L5] [31] (10.1177/1941738109338359)
  • [L4] [33] (10.1016/j.jse.2026.05.023)
  • [L4] [34] (10.1016/j.arthro.2016.08.029)
  • [L4] [35] (10.1177/19417381211029211)
  • [Paper] The step-by-step technique using standard anatomic landmarks and a measured resection approach provides a methodical method for safety, reproducibility, and optimization of scapulothoracic endoscopy. [36] (10.1016/j.eats.2015.05.010)
  • [L3] Anterior angulation of the medial scapula in the axial plane was associated with SSS. [38] (10.1016/j.jse.2014.12.034)
  • [L5] Postoperative 3D-CT of the scapula showed a complete resection of the curved area of the superior angle. [39] (10.1016/s1058-2746(03)00178-2)
  • [L5] The results of this study provide a large safe zone that can maximize the amount of bone that can be resected confidently from the superomedial corner of the scapula. [40] (10.1016/j.jse.2007.12.007)
  • [L3] Those patients with a concave-shaped scapula and a positive MSCA may be at risk for SSS. [75] (10.1177/2325967114s00063)

See Also

References

[1] Scapulothoracic Anatomy and Snapping Scapula Syndrome. Anatomy Research International. 2013. DOI: 10.1155/2013/635628

[2] Scapulothoracic bursectomy for snapping scapula syndrome. Journal of Shoulder and Elbow Surgery. 2002. DOI: 10.1067/mse.2002.120807

[3] Arthroscopic scapulothoracic bursectomy with and without superomedial angle scapuloplasty: a comparison of patient-reported outcomes. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.03.020

[4] Functional Outcomes After Arthroscopic Scapulothoracic Bursectomy and Partial Superomedial Angle Scapulectomy. Orthopaedic Journal of Sports Medicine. 2013. DOI: 10.1177/2325967113505739

[5] Technique and Outcomes of Arthroscopic Scapulothoracic Bursectomy and Partial Scapulectomy. Arthroscopy. 2012. DOI: 10.1016/j.arthro.2012.05.889

[6] Arthroscopic Treatment of Snapping Scapula Syndrome With Scapulothoracic Bursectomy and Partial Scapulectomy. Arthroscopy Techniques. 2022. DOI: 10.1016/j.eats.2022.02.028

[7] Symptomatic Scapulothoracic Crepitus and Bursitis. Journal of the American Academy of Orthopaedic Surgeons. 1998. DOI: 10.5435/00124635-199809000-00001

[8] Poster 134: Arthroscopic Surgery for Scapulothoracic Bursitis: A Comparison of Mid-Term Patient Reported Outcomes of Bone Resection versus Soft-Tissue-Only Debridement. Orthopaedic Journal of Sports Medicine. 2022. DOI: 10.1177/2325967121s00695

[9] Arthroscopic Scapulothoracic Decompression for Snapping Scapula Syndrome. Arthroscopy Techniques. 2015. DOI: 10.1016/j.eats.2015.07.002

[10] Outcome of Scapulothoracic Arthroscopy for Painful Snapping Scapula. The Open Orthopaedics Journal. 2017. DOI: 10.2174/1874325001711010785

[11] Surgical management of snapping scapula. Journal of Shoulder and Elbow Surgery. 1996. DOI: 10.1016/s1058-2746(96)80466-6

[13] Arthroscopic Management of Snapping Scapular Syndrome due to Recalcitrant Scapulothoracic Bursitis – A Case Series. Journal of Orthopaedic Case Reports. 2025. DOI: 10.13107/jocr.2025.v15.i02.5290

[15] The effectiveness of extracorporeal shock wave therapy in snapping scapula. Journal of Orthopaedic Surgery. 2017. DOI: 10.1177/2309499016684723

[16] Minimum 5-Year Clinical and Return-to-Sport Outcomes After Primary Arthroscopic Scapulothoracic Bursectomy and Partial Scapulectomy for Snapping Scapula Syndrome. The American Journal of Sports Medicine. 2024. DOI: 10.1177/03635465241243072

[17] Arthroscopic Management of Scapulothoracic Bursitis: Clinical Outcomes and Assessment of Novel Bony Parameters on Magnetic Resonance Imaging. Orthopaedic Journal of Sports Medicine. 2021. DOI: 10.1177/2325967121998273

[18] Snapping Scapula Syndrome: Diagnosis and Management. Journal of the American Academy of Orthopaedic Surgeons. 2013. DOI: 10.5435/jaaos-21-04-214

[19] Arthroscopic partial resection of the scapula for snapping scapula: A new technique. Journal of Shoulder and Elbow Surgery. 1999. DOI: 10.1016/s1058-2746(99)90056-3

[20] Outcomes after arthroscopic scapulothoracic bursectomy for the treatment of symptomatic snapping scapula syndrome. JSES International. 2022. DOI: 10.1016/j.jseint.2022.08.002

[21] Combined Arthroscopic Scapulothoracic Bursectomy, Partial Scapulectomy, and Pectoralis Minor Release for the Treatment of Snapping Scapular Syndrome. Arthroscopy Techniques. 2023. DOI: 10.1016/j.eats.2023.02.015

[22] Arthroscopic treatment for snapping scapula: a prospective case series. European Journal of Orthopaedic Surgery & Traumatology. 2013. DOI: 10.1007/s00590-012-1154-1

[23] Snapping scapula syndrome: current concepts review in conservative and surgical treatment. Muscles, Ligaments and Tendons Journal. 2013. DOI: 10.11138/mltj/2013.3.2.080

[24] Management of Recalcitrant Scapulothoracic Bursitis. Techniques in Shoulder & Elbow Surgery. 2006. DOI: 10.1097/bte.0b013e31802c9f31

[25] A Cadaveric Model Evaluating the Influence of Bony Anatomy and the Effectiveness of Partial Scapulectomy on Decompression of the Scapulothoracic Space in Snapping Scapula Syndrome. The American Journal of Sports Medicine. 2017. DOI: 10.1177/0363546516687755

[26] The Snapping Scapula: Diagnosis and Treatment. Arthroscopy. 2009. DOI: 10.1016/j.arthro.2008.12.022

[27] Full‐House Arthroscopic Treatment of Snapping Scapula Syndrome: Bursectomy, Levator Scapulae Release, and Partial Scapulectomy. Arthroscopy Techniques. 2025. DOI: 10.1016/j.eats.2025.103671

[28] Prognosis After Arthroscopic Superior Medial Scapuloplasty for Snapping Scapula Syndrome Improves After a Transient Beneficial Response With an Ultrasound‐Guided Subscapular Cortisone Injection. Arthroscopy. 2020. DOI: 10.1016/j.arthro.2020.07.024

[29] Arthroscopic management of snapping scapula syndrome improves pain and functional outcomes, although a high rate of residual symptoms has been reported. Knee Surgery, Sports Traumatology, Arthroscopy. 2017. DOI: 10.1007/s00167-017-4693-5

[30] An alternative portal for scapulothoracic arthroscopy. Journal of Shoulder and Elbow Surgery. 2002. DOI: 10.1067/mse.2002.121767

[31] Clinical Management of Scapulothoracic Bursitis and the Snapping Scapula. Sports Health: A Multidisciplinary Approach. 2010. DOI: 10.1177/1941738109338359

[33] Snapping Scapula Syndrome: A Systematic Review of Treatment Options and Outcomes. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.05.023

[34] Arthroscopic Treatment of Snapping Scapula Syndrome: Outcomes at Minimum of 2 Years. Arthroscopy. 2016. DOI: 10.1016/j.arthro.2016.08.029

[35] Diagnosis and Treatment of Snapping Scapula Syndrome: A Scoping Review. Sports Health: A Multidisciplinary Approach. 2021. DOI: 10.1177/19417381211029211

[36] Scapulothoracic Endoscopy for the Painful Snapping Scapula: Endoscopic Anatomy and Scapuloplasty Technique. Arthroscopy Techniques. 2015. DOI: 10.1016/j.eats.2015.05.010

[38] Association between scapula bony morphology and snapping scapula syndrome. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2014.12.034

[39] Snapping scapula caused by abnormal angulation of the superior angle of the scapula. Journal of Shoulder and Elbow Surgery. 2004. DOI: 10.1016/s1058-2746(03)00178-2

[40] Safe zone for arthroscopic resection of the superomedial scapular border in the treatment of snapping scapula syndrome. Journal of Shoulder and Elbow Surgery. 2008. DOI: 10.1016/j.jse.2007.12.007

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