Publication de Nicole Delepine : The frozen scapulothoracic space : A pathognomonic symptom of peri scapular fibromatosis.

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Publié sur : European Musculo Skeletal Oncology Society - Stuttgart - 2009
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The frozen scapulothoracic space : A pathognomonic symptom of peri scapular fibromatosis.
G. Delepine, H. Cornille, S.Alkallaf, B. Markowska, Nicole Delepine

The frozen scapulothoracic space : A pathognomonic symptom of peri scapular fibromatosis.



Introduction


The stiffness of the shoulder can result of many illness. Nevertheless, we observed a severe stiffness of the scapulo thoracic space only in fibromatosis.

frozen scapulothoracic space


Aim of the study


To precise the real diagnostic value of this symptom we examined patients with different diseases of shoulder, tumoral and non tumoral.
The passive mobility of the shoulder of every patient was analysed.

Method


For every patient we studied the mobility of scapulo humeral joint (1) and scapulothoracic space (2-1)

frozen scapulothoracic space


11 patients with peri-scapular fibromatosis

peri-scapular fibromatosis


50 patients with non tumoral diseases of shoulder
Arthritis and rotator cuff pathology.

tumoral diseases of shoulder


50 peri-scapular soft tissues tumours

peri-scapular soft tissues tumours


100 patients with primitive or secondary malignancies of humerus or scapula.

peri-scapular soft tissues tumours


Results


In 10 of 11 patients with peri-scapular fibromatosis, the passive mobility of the scapulo thoracic space was severely impaired (less than 20°).
In non tumoral pathology of shoulder, the passive mobility of the shoulder is frequently impaired but the stiffness hangs only on scapulo humeral articulation, the passive mobility of the scapulo thoracic space is normal.

In metastases, sarcoma and other soft tissue tumour the passive mobility of the scapulo-humeral joint is usually preserved and the mobility of the scapulothoracic space is always normal even in very huge tumours.

peri-scapular fibromatosis


After treatment of fibromatosis
9/11 patients are in complete remission and the mobility of their scapulo thoracic space is restored.

treatment of fibromatosis


Results of treatment
2 patients are in stable disease and one of these suffers of a residual stiffness of the scapulo-thoracic space due to radiotherapy.

treatment of fibromatosis


Conclusion


The frozen scapulo thoracic is a specific symptom of peri scapulo thoracic fibromatosis.
The restoration of the mobility of the scapulo thoracic after cure of the desmoid tumour confirms its specific role and represents a good marker of the tumoral evolution.






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