Subacromial bursitis: Difference between revisions

 
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==Background==
==Background==
[[File:Gray327.png|thumb|Shoulder bursa.]]
[[File:Shoulder_joint_back-en.png|thumb|Shoulder anatomy, anterior.]]
[[File:Shoulder_joint_back-en.png|thumb|Shoulder anatomy, anterior.]]
[[File:Shoulder joint back 05r4v.png|thumb|Shoulder anatomy, posterior.]]
*Inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, coracoid (the acromial arch) and from the deep surface of the deltoid muscle<ref>Salzman KL, Lillegard WA, Butcher JD (1997). "Upper extremity bursitis". Am Fam Physician 56 (7): 1797–806, 1811–2. PMID 9371010.</ref>
*Inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, coracoid (the acromial arch) and from the deep surface of the deltoid muscle<ref>Salzman KL, Lillegard WA, Butcher JD (1997). "Upper extremity bursitis". Am Fam Physician 56 (7): 1797–806, 1811–2. PMID 9371010.</ref>
*The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.
*The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.
*Commonly occurs in individuals who participate in repetitive overhead activities (athletes, manual laborers, and factory workers)<ref>Faruqi T, Rizvi TJ. Subacromial Bursitis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541096/</ref>


==Clinical Features==
==Clinical Features==
*Point tenderness at the anterolateral aspect of the shoulder below the acromion
*Pain with abduction of arm between 60-120 degrees


==Differential Diagnosis==
==Differential Diagnosis==
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==Evaluation==
==Evaluation==
===Workup===
*'''Labs'''
**Not usually indicated
**Consider [[synovial fluid analysis]] if concern for [[septic arthritis]]
*'''Imaging'''
**Not necessary for diagnosis
**Ultrasound may be helpful in measuring thickness of subacromial bursa
**Consider shoulder X-ray to rule out [[fractures]], [[dislocations]], [[osteoarthritis]], etc.
===Diagnosis===
*Typically a clinical diagnosis


==Management==
==Management==
*Non-operative management
**Rest, cold/heat, [[NSAIDs]]
**(+/-) [[Corticosteroid injection]]


==Disposition==
==Disposition==
*Most patients can be discharged and treated outpatient
*Consider admission if overlying cellulitis, signs of sepsis, or unable to tolerate pain


==See Also==
==See Also==
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==External Links==
==External Links==
*[https://www.physio-pedia.com/Shoulder_Bursitis Physiopedia - Shoulder Bursitis]


==References==
==References==

Latest revision as of 18:50, 6 July 2022

Background

Shoulder bursa.
Shoulder anatomy, anterior.
  • Inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, coracoid (the acromial arch) and from the deep surface of the deltoid muscle[1]
  • The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.
  • Commonly occurs in individuals who participate in repetitive overhead activities (athletes, manual laborers, and factory workers)[2]

Clinical Features

  • Point tenderness at the anterolateral aspect of the shoulder below the acromion
  • Pain with abduction of arm between 60-120 degrees

Differential Diagnosis

Shoulder and Upper Arm Diagnoses

Traumatic/Acute:

Nontraumatic/Chronic:

Refered pain & non-orthopedic causes:

Evaluation

Workup

Diagnosis

  • Typically a clinical diagnosis

Management

Disposition

  • Most patients can be discharged and treated outpatient
  • Consider admission if overlying cellulitis, signs of sepsis, or unable to tolerate pain

See Also

External Links

References

  1. Salzman KL, Lillegard WA, Butcher JD (1997). "Upper extremity bursitis". Am Fam Physician 56 (7): 1797–806, 1811–2. PMID 9371010.
  2. Faruqi T, Rizvi TJ. Subacromial Bursitis. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541096/