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Anatomy
Case report
Bony projection from lateral border of scapula
R Singh1*
Introduction
Scapula is a triangular bone with two
surfaces and three borders. The three
borders of the scapula are –Superior,
medial and lateral. The lateral border
extends from the infraglenoid tubercle
and inferior angle. Normally all
borders including the lateral border
are straight. But in the present case a
bony growth was found to be
projecting from lateral border. The
case is reported for its virgin
occurrence.
Case report
During osteology demonstration,
three scapulae were detected to have
bony growth projecting from the
lateral border of the scapula. The bony
growth is triangular in shape. This is a
new feature which may compress
neurovasucular structures. Average
distance of this bony growth from the
inferior tubercle is 7.8 cm, that from
inferior angle is 1.9cm. The lengths of
superior margin and that of inferior
margin of this bony outgrowth are 1.4
and 1.7 cm respectively. These may be
probably due to over strain/ stress
during biomechanical movements of
the scapula, calcium metabolism
disorder and defects of endrochondral
ossification or may be manifestation
of osteochondroma. The bony
outgrowths may impinge on the
surrounding
structures
causing
bundle
of
complications.
The
knowledge will be of utmost use to
anatomists, clinicians and radiologists.
Conclusion
The bony outgrowths may impinge on
the surrounding structures causing
bundles of complications. The
knowledge will be of utmost use to
anatomists, clinicians and radiologists.
*Corresponding author
Email: [email protected]
1
AIIMS, Rishikesh, India
Introduction
The scapula is a flat triangular bone. It
possesses body, three processes and
three borders. The superior border
extends from the superior angle to the
base of the coracoid process, medial
border from the superior angle to the
inferior angle and lateral border from
the base of the glenoid cavity to the
inferior angle. The lateral border gives
attachment to the teres minor in the
upper 2/3 part and teres major in the
lower 1/3 part of the lateral border.
The lateral border is also related to
the lower subscapular, thoracodorsal
nerves, subscapular artery and its
branch, the circumflex scapular artery.
The bony growth was detected arising
from the lateral border of the scapula.
The case is reported for its virgin
occurrence, analysing causes and
developing its clinical significance
along with improving radiological
interpretation.
Case report
During examination of scapulae in the
osteology lab, three scapulae were
found to have triangular bony growth
protruding from the lateral border of
the scapula. The lengths of the superior
and inferior margin are 1.4 and 1.7 cm
respectively. The incidence of the bony
growth was 3%. The average distance
of this bony growth from inferior angle
is 1.9cm and that from the infraglenoid
tubercle is 7.8cm.There was no other
abnormalities in these scapulae (Figure
1).
Discussion
Bony growths originating from bones
are categorised in three classes- Those
arising in joint margins known as
osteophytes, those arising at the sites of
attachments of tendons and ligaments
known as enthesophytes1 and those
occurring as bony tumours. The bony
growth in the present study is not
osteophyte as these are not present at
the magins of the joint. These are either
enthesophytes or tumour (may it be
cancerous?) of scapulae.
These might have been caused by
excessive strain during biomechanical
movements of scapula involving teres
major and teres minor muscles or due
to calcium metabolism disorder. They
may be part of new bone that can be
Figure 1: Bony growth from lateral border of scapula. GC-Glenoid cavity, CPCoracoid process, LT-Lateral border, BP- Bony projection, MB- Medial
border, SA-Superior angle, IA- Inferior angle.
Licensee OAPL (UK) 2014. Creative Commons Attribution License (CC-BY)
FOR CITATION PURPOSES: Rajani S. Bony projection from lateral border of scapula. OA Case Reports 2014 Apr
19;3(4):36.
Competing interests: None declared. Conflict of interests: None declared.
All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
Abstract
Page 2 of 2
formed at individual entheses in
response
to
a
seronegative
spondarthritis2. The individual might
have seronegative spondarthritis.
More commonly, they are seen in
several sites as part of the condition
first described in the spine by
Forrestier and Rotes-Quero and now
known as diffuse idiopathic skeletal
hyperostosis3 (DISH). It may be part of
the tumour of the scapula like
osteochondroma of bone. If such types
of bony growth are encountered then
the individual should be examined for
signs and symptoms of seronegative
spondarthritis and DISH syndrome or
complaints of osteochondroma.
Bony projections have been reported
projecting from Foramen magnum4,
Obturator foramen5, External occipital
protuberance6, Iliac crest7 and
olecranon process of ulna8. But bony
growths from the lateral border of the
scapula are not described in standard
text books. Since the lateral border is
related to the lower subscapular
nerve, thoracodorsal nerve, the
subscapular artery lies near the
vicinity of the bony projection which
may be damaged leading to
neurovascular complications.
2. Smillie IS. Injuries of the knee joint.
1970
(Churchill
Livingstone,
Edinburgh).
3. Resnick D, Shaul SR, Robins JM.
Diffuse
idiopathic
skeletal
hyperostosis
(DISH).
Forrestiers
disease
with
extra
spinal
manifestations.
Radiology.
1975,
115:513–524.
4. Pastor Vazquez JF, Gil Verona JA,
Moro Balbas JA, Garcia M, Porrero,
and Barbosa Ayucar E. Tubercie at the
Foramen Magnum. Skull Base Surgery.
1996, 6(3): 169-170.
5. Singh R. Bony spurs projecting in
the obturator foramen. Folia Morphol.
2012; 71(2): 125-127.
6. Singh R. Bony tubercle at external
occipital protuberance and prominent
ridges. J Craniofac Surg. 2012; 23
(6):1873-4.
7. Philips P and Deepak M. KamatPediatrics
consultant
live.
www.pediatrics consultant live.com
Topics centers/ Photoclinic, Dec. 2010
8. Singh R. Bony projection from the
olecranon process of ulna. Int J Biol
Med Res. 2012; 3(4): 2653-2654.
Not only this teres major muscle may
be impinged by this growth leading to
spasm and pain during biomechanical
movements of scapula. Moreover, the
bony growth may mislead the
radiologist for abnormal structure.
Thus knowledge of this type of bony
projection may be of paramount
importance to anatomists, clinicians
and radiologists.
Conclusion
The bony outgrowths may impinge on
the surrounding structures causing
bundles of complications. The
knowledge will be of utmost use to
anatomists, clinicians and radiologists.
References
1. Resnick D, Niwayama G. Enthesis
and
enthesopathy:
anatomical,
pathological
and
radiological
correlation. Radiology. 1983,146:1–9.
Licensee OAPL (UK) 2014. Creative Commons Attribution License (CC-BY)
FOR CITATION PURPOSES: Rajani S. Bony projection from lateral border of scapula. OA Case Reports 2014 Apr
19;3(4):36.
Competing interests: None declared. Conflict of interests: None declared.
All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
Case report