Spontaneous fracture of the lower angle of scapula. Possible role of cough.

We report a case of a fracture of the inferior angle of the scapula related to prolonged cough, without triggering trauma, sport, or occupational activity. Bone insufficiency was present in this patient. Stress fractures of the scapula are rare; the fatigue type is the most frequent, associated with sports or occupational activity. We do not find any published case report about scapula stress fracture related to cough, until rib fractures are frequent in this situation. Repetitive muscular activity of the serratus anterior and major rhomboid on the inferior angle of the scapula during cough may explain this avulsion fracture.