scapulothoracala

Scapulothoracala refers to the scapulothoracic interface, the functional relationship between the scapula (shoulder blade) and the thoracic wall. It is not considered a true synovial joint; rather, the scapula slides over the thoracic cage, with movement supported by muscles, bursae, and connective tissues that form a dynamic barrier and stabilizing platform.

Anatomy and movement: The scapulothoracal interface involves the anterior surface of the scapula gliding along the rib cage, typically over ribs 2 through 7. Periscapular muscles—most notably the serratus anterior, trapezius, rhomboids, levator scapulae, and the pectoralis minor—drive and control motion. Scapular motion contributes to arm elevation through a coordinated scapulohumeral rhythm, including elevation, depression, protraction, retraction, and upward or downward rotation. Proper function depends on balance among these muscles and on thoracic mobility.

Clinical relevance: Scapulothoracala dysfunction can cause anterior shoulder or flank pain, particularly in overhead and throwing activities. Conditions include scapulothoracic pain and stiffness, scapulothoracic bursitis, and snapping scapula syndrome, where bursal irritation or bone/p soft tissue abnormalities produce audible or palpable snapping during movement. Scapular dyskinesis, often from muscular imbalance or nerve injury (such as the long thoracic nerve), can accompany various shoulder pathologies.

Diagnosis and treatment: Evaluation emphasizes history, observation of scapular motion, and functional testing during arm elevation. Imaging is used selectively to identify structural causes. Management is usually conservative: physical therapy to strengthen stabilizing periscapular muscles, improve posture, and restore coordinated scapular motion; activity modification; NSAIDs or corticosteroid injections for inflammation. Surgery is rare and reserved for refractory cases, such as persistent snapping scapula unresponsive to therapy.