Bilateral pneumothoraces.

authors state that bony causes produced static winging which is present at rest and may be accentuated by certain passive shoulder movements. Cooley & Torg (1982) described what they termed 'pseudowinging' of the scapula produced by subscapular osteochondroma. They stressed that although subtle points of differentiation might allow the diagnosis to be suspected, the condition was liable to be confused with classical winging produced by serratus anterior paralysis. Indeed, in the case described, the latter diagnosis had initially been made by two specialists and spontaneous resolution predicted. In the case described above, radiology alone led to the correct diagnosis. The possibly misleading acute onset of symptoms was suggestive of a neurological cause. Also the winging was dynamic in that it was more prominent on asking the patient to push against a wall with both outstretched arms. A plea is made for considering X-rays as part of the basic assessment of the apparently winged scapula.