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subacromial bursitis

Also see bursitis. Etiology: - commonly associated with impingement syndrome caused by overhead activities Clinical manifestations: 1) pain with raising arms above head 2) pain may radiate to lateral deltoid 3) pain on palpation of the anterolateral aspect of the shoulder - tenderness should localize to lateral edge of acromion 4) pain on resisted abduction beyond 75 degrees, 5) muscle atrophy or weakness should raise suspicion of rotator cuff injury Differential diagnosis: - acromioclavicular arthritis - pain with palpation of the acromioclavicular joint - provocative maneuvers including the cross-body adduction test - radiographic findings of osteoarthritis Management: - physical therapy - arthroscopic subacromial decompression* is a common surgery for subacromial shoulder pain but of questionable value [5] * decompressing subacromial space by removing bone spurs & soft tissue

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subacromial bursa

General

bursitis

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 673-74
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  4. Ottenheijm RP, Jansen MJ, Staal JB et al Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2010 Oct;91(10):1616-25 PMID: 20875523
  5. Beard DJ, Rees JL, Cook JA et al Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo- controlled, three-group, randomised surgical trial. Lancet Nov 20, 2017 PMID: 29169668 Free full text http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32457-1/fulltext