Interscapular pain

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Interscapular pain is pain localized in the interscapular area between the shoulder blades. The most common causes of interscapular pain are due to secondary disease conditons. Primary causes of interscapular pain are rare.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	Acute myocardial infarction, aneurysm of sinus of valsalva, aortic dissection, aortic hammer syndrome, dissecting aortic aneurysm, dissecting intramural hematoma of the esophagus (DIHE), pulmonary embolism, ruptured aortic aneurysm
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	Necrotizing fasciitis
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Dissecting intramural hematoma of the esophagus (DIHE)
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	Chikungunya, Guillain-Barre syndrome, necrotizing fasciitis, posterior mediastinal abscess, spinal epidural abscess
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

Acromioclavicular joint disclocation
Acute myocardial infarction
Aneurysm of sinus of valsalva^[3]
Ankylosing spondylitis
Aortic dissection
Aortic hammer syndrome^[4]
Autosomal dominant polycystic kidney disease^[5]
Cervical disc disease
Cervical radiculopathy^[6]
Chikungunya
Chronic fatigue syndrome
Disc prolapse
Dislocated shoulder^[7]
Dissecting aortic aneurysm^[8]
Dissecting intramural hematoma of the esophagus (DIHE)^[9]
Dorsal scapular nerve entrapment^[10]
Fibromyalgia
Guillain-Barre syndrome^[11]

↑ Somasamudra P, Smith E, Tandan R (2011). "Aortic dissection presenting as pleural effusion". BMJ Case Rep. 2011. doi:10.1136/bcr.03.2011.3956. PMC 3118903. PMID 22692486.
↑ Zanobetti M, Bigiarini S, Coppa A, Conti A, Innocenti F, Pini R (2012). "Usefulness of chest ultrasonography in detecting pulmonary embolism in patient with chronic obstructive pulmonary disease and chronic renal failure: a case report". Am J Emerg Med. 30 (8): 1665.e1–3. doi:10.1016/j.ajem.2011.09.021. PMID 22154162.
↑ Lescan M, Walker T, Kobba J, Schneider W, Schlensak C (2014). "The preoperative management of a patient with a large aneurysm of the sinus of valsalva and takotsubo cardiomyopathy". Gen Thorac Cardiovasc Surg. 62 (1): 64–7. doi:10.1007/s11748-013-0212-x. PMID 23378016.
↑ Komen N, Vercauteren S, de Roover D (2011). "Aortic hammer syndrome". J Endovasc Ther. 18 (4): 497–500. doi:10.1583/11-3475.1. PMID 21861736.
↑ Rodrigues L, Neves M, Machado S, Sá H, Macário F, Alves R; et al. (2012). "Uncommon cause of chest pain in a renal transplantation patient with autosomal dominant polycystic kidney disease: a case report". Transplant Proc. 44 (8): 2507–9. doi:10.1016/j.transproceed.2012.07.014. PMID 23026633.
↑ Tanaka Y, Kokubun S, Sato T, Ozawa H (2006). "Cervical roots as origin of pain in the neck or scapular regions". Spine (Phila Pa 1976). 31 (17): E568–73. doi:10.1097/01.brs.0000229261.02816.48. PMID 16924193.
↑ Barbier O, Van Gaver E, Rigal S (2010). "[A bilateral posterior shoulder dislocation caused by humeral head osteonecrosis]". Chir Main. 29 (1): 48–51. doi:10.1016/j.main.2009.11.008. PMID 20093062.
↑ Fukushima K, Kamisawa O, Yamaguchi T, Misawa Y, Kato M, Hasegawa T (1992). "[Dissecting aortic aneurysm involving an aberrant right subclavian artery]". Nihon Kyobu Geka Gakkai Zasshi. 40 (2): 278–81. PMID 1593169.
↑ Pomara C, Bello S, D'Errico S, Greco M, Fineschi V (2013). "Sudden death due to a dissecting intramural hematoma of the esophagus (DIHE) in a woman with severe neurofibromatosis-related scoliosis". Forensic Sci Int. 228 (1–3): e71–5. doi:10.1016/j.forsciint.2013.02.005. PMID 23453641.
↑ Sultan HE, Younis El-Tantawi GA (2013). "Role of dorsal scapular nerve entrapment in unilateral interscapular pain". Arch Phys Med Rehabil. 94 (6): 1118–25. doi:10.1016/j.apmr.2012.11.040. PMID 23220342.
↑ Ruts L, van Koningsveld R, Jacobs BC, van Doorn PA (2007). "Determination of pain and response to methylprednisolone in Guillain-Barré syndrome". J Neurol. 254 (10): 1318–22. doi:10.1007/s00415-006-0515-2. PMC 2778673. PMID 17426908.
↑ Rostgaard-Knudsen M, Holst-Hansen C, Schønheyder HC (2011). "[Necrotising fasciitis in a patient infected by Streptococcus pneumoniae]". Ugeskr Laeger. 173 (24): 1732–4. PMID 21696680.
↑ Ahmad R, Ishlah W, Shaharudin MH, Sathananthar KS, Norie A (2008). "Posterior mediastinal abscess secondary to esophageal perforation following fish bone ingestion". Med J Malaysia. 63 (2): 162–3. PMID 18942310.

[pmid22692486-1] Somasamudra P, Smith E, Tandan R (2011). "Aortic dissection presenting as pleural effusion". BMJ Case Rep. 2011. doi:10.1136/bcr.03.2011.3956. PMC 3118903. PMID 22692486.

[pmid22154162-2] Zanobetti M, Bigiarini S, Coppa A, Conti A, Innocenti F, Pini R (2012). "Usefulness of chest ultrasonography in detecting pulmonary embolism in patient with chronic obstructive pulmonary disease and chronic renal failure: a case report". Am J Emerg Med. 30 (8): 1665.e1–3. doi:10.1016/j.ajem.2011.09.021. PMID 22154162.

[pmid23378016-3] Lescan M, Walker T, Kobba J, Schneider W, Schlensak C (2014). "The preoperative management of a patient with a large aneurysm of the sinus of valsalva and takotsubo cardiomyopathy". Gen Thorac Cardiovasc Surg. 62 (1): 64–7. doi:10.1007/s11748-013-0212-x. PMID 23378016.

[pmid21861736-4] Komen N, Vercauteren S, de Roover D (2011). "Aortic hammer syndrome". J Endovasc Ther. 18 (4): 497–500. doi:10.1583/11-3475.1. PMID 21861736.

[pmid23026633-5] Rodrigues L, Neves M, Machado S, Sá H, Macário F, Alves R; et al. (2012). "Uncommon cause of chest pain in a renal transplantation patient with autosomal dominant polycystic kidney disease: a case report". Transplant Proc. 44 (8): 2507–9. doi:10.1016/j.transproceed.2012.07.014. PMID 23026633.

[pmid16924193-6] Tanaka Y, Kokubun S, Sato T, Ozawa H (2006). "Cervical roots as origin of pain in the neck or scapular regions". Spine (Phila Pa 1976). 31 (17): E568–73. doi:10.1097/01.brs.0000229261.02816.48. PMID 16924193.

[pmid20093062-7] Barbier O, Van Gaver E, Rigal S (2010). "[A bilateral posterior shoulder dislocation caused by humeral head osteonecrosis]". Chir Main. 29 (1): 48–51. doi:10.1016/j.main.2009.11.008. PMID 20093062.

[pmid1593169-8] Fukushima K, Kamisawa O, Yamaguchi T, Misawa Y, Kato M, Hasegawa T (1992). "[Dissecting aortic aneurysm involving an aberrant right subclavian artery]". Nihon Kyobu Geka Gakkai Zasshi. 40 (2): 278–81. PMID 1593169.

[pmid23453641-9] Pomara C, Bello S, D'Errico S, Greco M, Fineschi V (2013). "Sudden death due to a dissecting intramural hematoma of the esophagus (DIHE) in a woman with severe neurofibromatosis-related scoliosis". Forensic Sci Int. 228 (1–3): e71–5. doi:10.1016/j.forsciint.2013.02.005. PMID 23453641.

[pmid23220342-10] Sultan HE, Younis El-Tantawi GA (2013). "Role of dorsal scapular nerve entrapment in unilateral interscapular pain". Arch Phys Med Rehabil. 94 (6): 1118–25. doi:10.1016/j.apmr.2012.11.040. PMID 23220342.

[pmid17426908-11] Ruts L, van Koningsveld R, Jacobs BC, van Doorn PA (2007). "Determination of pain and response to methylprednisolone in Guillain-Barré syndrome". J Neurol. 254 (10): 1318–22. doi:10.1007/s00415-006-0515-2. PMC 2778673. PMID 17426908.

[pmid21696680-12] Rostgaard-Knudsen M, Holst-Hansen C, Schønheyder HC (2011). "[Necrotising fasciitis in a patient infected by Streptococcus pneumoniae]". Ugeskr Laeger. 173 (24): 1732–4. PMID 21696680.

[pmid18942310-13] Ahmad R, Ishlah W, Shaharudin MH, Sathananthar KS, Norie A (2008). "Posterior mediastinal abscess secondary to esophageal perforation following fish bone ingestion". Med J Malaysia. 63 (2): 162–3. PMID 18942310.

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