ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Diagnosis And Treatment Of Snapping Scapula Syndrome: A Scoping Review

Hassan Baldawi, MB, BCh, BAO, MSc (Candidate) , Hamilton, Ontario CANADA
Kyle Gouveia, MD, Hamilton, ON CANADA
Chetan Gohal, MD, Hamilton, ON CANADA
Latifah Al Mana, MBBS, Hamilton CANADA
Ryan Paul, MD, MSc, FRCSC, Toronto CANADA
Bashar Alolabi, MD, MSc, FRCSC, Hamilton, ON CANADA
Jaydeep Moro, MD, FRCSC, Hamilton, ON CANADA
Moin Khan, MD, MSc, FRCSC, Hamilton, ON CANADA

McMaster University, Hamilton, ON, CANADA

FDA Status Cleared

Summary

Focused history and physical examination is the most crucial initial step in the diagnostic process, with supplemental imaging used to assess for structural etiologies when non-operative management fails

ePosters will be available shortly before Congress

Abstract

Objective

This scoping review aims to summarize the current evidence related to SSS diagnosis and treatment to aid clinicians in managing the condition more effectively. Data Sources: PubMed, Medline, and Embase databases searched for studies related to SSS's etiology, diagnosis, or treatment. Study Selection: Databases were searched for available studies related to the etiology, diagnosis or treatment of SSS.

Study Design: A scoping review study design was selected to explore the breadth of knowledge in the literature regarding SSS diagnosis and treatment.

Data Extraction: Primary outcomes abstraction included accuracy of diagnostic tests, functional outcomes and pain relief associated with various non-operative and operative
treatment options for SSS.

Main Results: 1442 references were screened and 40 met inclusion criteria. Studies commonly reported SSS as a clinical diagnosis and relied heavily on a focused history and physical examination. The most common signs reported were medial scapular border tenderness, crepitus, and audible snapping. 3-Dimensional Computed Tomography (3D-CT) had high inter-rater reliability (IRR) of 0.972,1 with a 100% success rate in identifying symptomatic incongruity of the scapular articular surface. 38 Initial non-operative treatment was reported to be successful in most symptomatic patients, with an improved Visual Analogue Scale scores (7.7 ± 0.5 pre-treatment, to 2.4 ± 0.6 ). Persistently symptomatic patients underwent surgical intervention most commonly involving bursectomy, superomedial angle resection, or partial scapulectomy. High satisfaction rates of surgery were reported in VAS (6.9 ± 0.7 to 1.9 ± 0.9), ASES scores ( 50.3 ± 12.2 to 80.6 ± 14.9) and mean SST scores ( 5.6 ± 1.0 to 10.2 ± 1.1).

Conclusion

Focused history and physical examination is the most crucial initial step in the diagnostic process, with supplemental imaging used to assess for structural etiologies when non-operative management fails. Non-operative management is as effective as surgical management in pain relief and is advised for 3-6 months before operative treatment.

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