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

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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.

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)



11 patients with peri-scapular fibromatosis



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



50 peri-scapular soft tissues tumours



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

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.



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



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.

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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