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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]
The subcoracoid bursa does not communicate with the glenohumeral joint under normal circumstances, but may communicate with the subacromial bursa. [1] As such, contrast fluid injected into the glenohumeral joint during an arthrogram that extends into the subcoracoid bursa is abnormal, and indirectly implies a full thickness rotator cuff tear. [2]
The subacromial bursa is the synovial cavity located just below the acromion, which communicates with the subdeltoid bursa in most individuals, forming the so-called subacromial-subdeltoid bursa (SSB).
Thickening or calcification of the coracoacromial ligament can also cause impingement. Loss of function of the rotator cuff muscles, due to injury or loss of strength, may cause the humerus to move superiorly, resulting in impingement. Inflammation and subsequent thickening of the subacromial bursa may also cause impingement. [2]
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 skin and bone). Inflammation of the bursae is called bursitis.
Localized pain on the anterior shoulder suggests subacromial impingement, whereas posterior shoulder pain suggests internal impingement. [45] For the diagnosis of full-thickness rotator cuff tear, the best combination appears to include once more the painful arc and weakness in external rotation, and in addition, the drop arm sign . [ 42 ]
These include the subacromial, prepatellar, retrocalcaneal, and pes anserinus bursae of the shoulder, knee, heel and shin, etc. (see below [broken anchor]). [1] Symptoms vary from localized warmth and erythema (redness) [ 1 ] to joint pain and stiffness, to stinging pain that surrounds the joint around the inflamed bursa.
The supra-acromial bursa is located on the superior aspect of the acromion and normally does not communicate with the glenohumeral joint. [1] Supra-acromial bursitis has not been receiving much attention from literature and remains described mainly as case reports of presumptive diagnosis with no histopathological correlation. [ 2 ]