Pain accompanied by loud noises in the scapulothoracic joint between the shoulder blade and ribs can occur due to inflammation, bony or soft tissue lumps under the shoulder blade, or abnormal muscle rhythm. Your surgeon will advise advanced imaging in form of a CT scan anda MRI scan to determine the cause. You will be given physiotherapy to re-train muscles of the shoulder blade, and a steroid injection into the scapulothoracic joint (bursa) to reduce the inflammation. If lumps remain and there has been no resolution of the symptoms, the surgeon will recommend minimally invasive surgery (scapulothoracic arthroscopy).