Abstract
Objectives: An abnormal ossification process in soft tissues at the attachment site to a bone is called enthesopathy due to biomechanical movements of bone. The present study aimed to observe the calcification of the transverse scapular ligament (TSL) with complete or partial ossification, the presence of the triangular bony growth at the lateral border of scapula and to observe vascular foramen/foramina piercing at the bases of the spine of scapulae.
 Methods: An observational study was conducted on dried human scapulae 140 in number (70 right and 70 left) of unknown sex and age, procured from the Department of Anatomy, People’s College of Medical Science and Research Center, Bhopal, and Government Doon Medical College, Dehradun, India. These scapulae were studied to observe enthesopathic changes in them. Measurements were taken with Vernier calipers.
 Results: In the present study, we observed the presence of completely ossified TSL with formation of complete suprascapular foramina in 8.57% scapulae. The incidence of triangular bony growth at the lateral border of scapula was found in 40% scapulae of the right side and 32.85% of the left. The incidence of vascular foramina piercing at the bases of the spine of scapulae was 17.14% on the right side and 21.42% on the left side scapulae.
 Conclusion: The study provides the descriptive knowledge of enthesopathy in scapulae. The study is of great significance for neurosurgeons and orthosurgeons to carry out various reconstructive surgeries.
Highlights
The usual attachment or insertion site of a tendon, muscle, capsule, or ligament to a bone is called the enthesis which is very active metabolically
The present study was an observational study on dried human scapulae aimed to study the calcification of the transverse scapular ligament (TSL) with complete or partial ossification, the presence of the triangular bony growth at the lateral border of the scapula and to observe vascular foramen/foramina piercing at the bases of the spine of scapulae
The present study showed the presence of complete TSL in 12 scapulae with the formation of suprascapular foramina (Fig. 1) of maximum and minimum lengths of foramen as 1.3 cm and 0.1cm, respectively, while 0.8 cm maximum width and 0.1 cm minimum width (Table 1)
Summary
The usual attachment or insertion site of a tendon, muscle, capsule, or ligament to a bone is called the enthesis which is very active metabolically. Any disruption from the normal at these sites called enthesopathy having multifactorial causes such as inflammatory changes along with diseases of bone followed by bone erosions and is slowly replaced by endochondral ossification as the healing process (Enthesitis), degenerative (prone in old age) changes as hyperostosis (e.g., Diffuse Idiopathic Skeletal Hyperostosis [DISH]), endocrine disorders such as diabetes mellitus, hypo- and hyperparathyroidism, deposition of calcium pyrophosphate dehydrate (CPPD) crystals, trauma, and its related factors and diseases such as fluorosis, plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy (POEM syndrome), and skin changes [1] These sites when undergo abrasions, stress, or stain due to biomechanical movements of bones act as focal site of abnormal calcification and ossification of bones involving disorders in calcium metabolism, degeneration process, as well as systemic disorders act as an additional predisposing factor, leading to abnormal ossification process in the soft tissues. The present study was an observational study on dried human scapulae aimed to study the calcification of the TSL with complete or partial ossification, the presence of the triangular bony growth at the lateral border of the scapula and to observe vascular foramen/foramina piercing at the bases of the spine of scapulae
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