The operative treatment of scapulothoracic bursitis in professional pitchers.

Four professional pitchers with resistant scapulothoracic bursitis who have required surgical excision of the thickened bursa are reported. The average time duration of symptoms prior to surgery was 18.8 months. Conservative therapy consisting of rest, shoulder exercises, antiinflammatory medications, and cortisone injections failed to resolve the bursitis, and each pitcher was unable to compete secondary to pain. The incision was posterior, just distal to the tip of the scapula. The specimens contained cleft-like spaces lined by synovial tissue consistent with a bursa. All four pitchers returned to professional baseball the year following surgical excision of the bursa. We recommend early, aggressive, conservative therapy for scapulothoracic bursitis in the throwing athlete. Pitchers with a thickened, resistant scapulothoracic bursitis should have the bursa surgically excised.