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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]
If conservative measures are unsuccessful, surgery can be trialed. Surgery to cut the adhesions (capsular release) may be indicated in prolonged and severe cases; the procedure is usually performed by arthroscopy. Surgical evaluation of other problems with the shoulder, e.g., subacromial bursitis or rotator cuff tear, may be needed.
A meta-analysis in 2008 concluded that the diagnostic accuracy of individual tests in the shoulder examination was limited, specifically that the Hawkins–Kennedy test and the Speed test have no discriminatory ability to diagnose specific shoulder pathology, and that results of studies evaluating other tests were too statistically ...
Calcific bursitis refers to calcium deposits within the bursae. This most occurs in the shoulder area. The most common bursa for calcific bursitis to occur is the subacromial bursa. A bursa is a small, fluid-filled sac that reduces friction, and facilitates movements between its adjacent tissues (i.e., between tendon and bone, two muscles or ...
On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test). These tests help localize the pathology to the rotator cuff; however, they are not specific for impingement. [16] Neer sign may also be seen with subacromial bursitis. [17]
Bursae of shoulder joint: (1) and (6) subacromial-subdeltoid bursa, (2) subscapular recess, (3) subcoracoid bursa, (4) coracoclavicular bursa, (5) supra-acromial bursa. A number of small fluid-filled sacs known as synovial bursae are located around the capsule to aid mobility: Between the joint capsule and the deltoid muscle is the subacromial ...
V ECF a = Extracellular fluid volume after fluid loss; n ECF a = Amount of substance in ECF after fluid loss; V ECF b = Extracellular fluid volume before fluid loss (approximately 20% of body weight, or by using inulin) Osm b = Body osmolarity before loss (almost equal to plasma osmolality of 275-299 milli-osmoles per kilogram [4])
The RICE method is an effective procedure used in the initial treatment of a soft tissue injury. [6] Rest It is suggested that the patient take a break from the activity that caused the injury in order to give the injury time to heal. Ice The injury should be iced on and off in 20 minute intervals, avoiding direct contact of the ice with the skin.