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For many years I have occasionally heard confusing adventitious sounds over the scapular areas during ausculation of the organs of respiration. They may be of a creaking, crunching or bubbling character, and may occur during either or both phases of respiration. They are somewhat superficial and are confined to the scapular areas, or, if they extend outside, lose considerably in intensity at the bone margin. Displacement of the scapulæoe forward causes them to disappear, and clear respiratory sounds are now audible when the stethoscope is placed over the same pulmonary area.
I have been able to demonstrate these sounds to students in the clinic and have hitherto listed them under the term "the scapula rub." Three well-marked cases of late have enabled me, however, to trace their origin. In all three cases they were produced in the apparently healthy shoulder-joint during its respiratory movement. From this position of maximum intensity they
COOPER CM. RESPIRATORY JOINT CREPITATIONS. JAMA. 1910;LIV(23):1865. doi:10.1001/jama.1910.92550490006002k
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