Idiopathic snapping scapula in a Moroccan patient: A rare cause of shoulder pain

摘要

Introduction The jumped shoulder blade or “snapping scapula” is a rare cause of shoulder pain that entails cracking of the scapula in connection with multiple causes. In 30% of cases no etiology is found. Case presentation We report a case of a 54 year old Moroccan male patient with left shoulder pain lasting for 14 years associated with pain at the anterior-upper corner of the scapula. Clinical examination did not reveal any deformation of neither cervical nor thoracic spine on inspection; testing of the tendons of the shoulder rotators and active and passive shoulder mobility were normal and an audible crack was noted during the arm movement or apprehension test with left arm pain on mobilization of the scapula “vital sign” without limitation of the range of motion. The anterior drawer sign of laxity and refocusing sign were negative. Imaging performed including plain radiographs, musculoskeletal ultrasound and CT scan of the scapula with 3D image reconstruction found no bone or soft tissue abnormalities that could explain this syndrome. The diagnosis of jumped scapula of unknown origin was made and symptomatic treatment with non-steroidal anti-inflammatory drugs and a rehabilitation protocol based on isometric and isotonic strengthening periscapular muscles, posture and endurance exercises were instituted. Conclusion Our case illustrates a new case of a jumped shoulder blade of unknown origin after completion of all etiological imaging. Further analysis of clinical events is needed to better understand this type of jumped shoulder blade.