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Aug 14, 2017Article Details
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Main Article Content
The scapulocostal syndrome
Abstract
The scapulocostal syndrome, a hitherto insufficiently understood condition, was clinically studied in 201 cases. The main findings were: (i) pain was the presenting symptom in all cases and was mainly cervicobrachial (90%); (ii) the syndrome is a definable entity within the wide spectrum of fibromyalgia (fibrositis); (iii) the pain originates mainly from an enthesopathy of the serratus posterior superior muscle; and (iv) physical degeneration was present in 76,5% of patients.
Conservative treatment, successful in 95,9% of cases, consisted of an intralesional injection of a steroid-analgesicmixture of 1 ml Celestone-Soluspan (Scherag) plus 1,8 ml Xylotox E80A (Astra), and physical rehabilitation. It was deducted that the dyskinesia was mainly due to an overload of the scapulocostal articulation, forcing the rib cage down to exert a stretching force on the serratus posterior superior muscle. The operation of 'serratotomy' (severing the serratus posterior superior muscle) was performed with excellent results in 6 patients in whom conservative treatment failed, and is described here for the first time.
