The thoracic borders of the scapula are best palpated unilaterally from behind. Commence at the medial limit of the spinous process where it meets the vertebral border. This is at the level of the T3 vertebral spinous process.
The vertebral (medial) border is approximately 3-4 cm lateral to the spinous processes of the thoracic vertebrae. Palpating superiorly, the superomedial angle is located at the level of the second rib. Frequently, it is indistinct given its cover by levator scapulae.
Palpating inferiorly, the inferomedial angle is more distinct. It is located at the level of the seventh rib. It is used as a landmark to find the lateral border of the scapula by progression obliquely and superolateral. It is harder to distinguish than the vertebral border given the coverage by latissimus dorsi, teres major and teres minor sweeping anteriorly.
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