Small bursae between the digitations of serratus anterior and the underlying costal periosteum, reducing friction as the muscle slips contract during scapular protraction and upward rotation. They are most prominent at the mid-lateral thorax where the muscle belly is thickest.
Serratus anterior costal bursitis contributes to lateral chest wall pain in overhead athletes and rowers, where repetitive forceful scapular protraction loads the serratus origin. It is distinguished from intercostal neuralgia by its lateral rather than circumferential distribution. Rib stress fractures from serratus traction may coexist. Ultrasound-guided injection targets the serratus-rib interface.
Lateral chest wall pain from serratus costal bursal inflammation in overhead athletes, reproduced by resisted scapular protraction and managed with activity modification and ultrasound-guided injection.
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