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Subacromial bursitis is a condition caused by 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, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]
With minor trauma, nodules are shed as small bodies into the joint space. In some patients, the disease process may involve tendon sheaths and bursal sacs. Cartilaginous intra-articular bodies float freely within the synovial fluid, which they require for nutrition and growth. Progressive enlargement and ossification occur with time.
Joint space narrowing, with or without subchondral sclerosis. Joint space narrowing is defined by this system as a joint space less than 3 mm, or less than half of the space in the other compartment, or less than half of the space of the homologous compartment of the other knee. II: Obliteration of the joint space III: Bone defect/loss < 5 mm IV
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Surgery may be done arthroscopically or as open surgery. The impinging structures may be removed in surgery, and the subacromial space may be widened by resection of the distal clavicle and excision of osteophytes on the under-surface of the acromioclavicular joint. [4] Damaged rotator cuff muscles can be surgically repaired.
Recently, there has been a published case report of decrease in knee pain in a single individual using autologous mesenchymal stem cells. An advantage to this approach is that a person's own stem cells are used, avoiding transmission of genetic diseases. It is also minimally invasive, minimally painful and has a very short recovery period.
The joint space equals the distance between the involved bones of the joint. A joint space narrowing is a sign of either (or both) osteoarthritis and inflammatory degeneration. [12] The normal joint space is at least 2 mm in the hip (at the superior acetabulum), [13] at least 3 mm in the knee, [14] and 4–5 mm in the shoulder joint. [15]
The knee bursae are the fluid-filled sacs and synovial pockets that surround and sometimes communicate with the knee joint cavity. The bursae are thin-walled, and filled with synovial fluid . They represent the weak point of the joint, but also provide enlargements to the joint space. [ 1 ]
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