The Shoulder
Shoulder Girdle
Idiopathic contracture of the costocoracoid fascia
The costocoracoid fascia connects the caudal aspect of the coracoid process with the anterior aspect of the upper ribs.
costo-coracoid fascia is a fibrous sheet at the pectoral side of the pectoralis minor muscle.
Contracture of the fascia may provoke a limitation in scapular movements. This is however, an extremely rare cause of clavipectoral pain.
- pectoralis major muscle
- brachioradialis muscle and short head of biceps
- costo-coracoid fascia
- pectoralis minor muscle
Causes
Impaired elasticity of the costocoracoid fascia may be caused by:
- (Healed) apical tuberculosis of the lung.
- After radiation therapy for cancer of the breast.
- In relation to a (direct) trauma - fibrotic reaction on a haematoma between the fascia and the ribs.
- Idiopathically.
Symptoms and Signs
- Clavipectoral pain on elevation of the arm.
- Active and passive elevation of the arm is painful and slightly (10 to 20°) limited.
- Active and passive elevation of the scapula is slightly limited and painful, the other passive movements are free.
- Resisted movements of shoulder and shoulder girdle are completely normal.
Treatment
Surgical section of the fascia.
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