Subacromial bursitis: Difference between revisions

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==Overview==
==Overview==
'''Subacromial bursitis''' is [[inflammation]] of the subacromial [[bursa]], which lies between the [[acromion]] and the head of the [[humerus]] leading to extreme pain.
'''Subacromial bursitis''' is [[inflammation]] of the subacromial [[bursa]], which lies between the [[acromion]] and the head of the [[humerus]] leading to extreme pain.


==Differential diagnosis of causes of subacromial bursitis==
==Differentiating Subacromial bursitis from other Diseases==
The cause of the condition is often unclear. It can in some cases be blamed either on repeated minor [[Physical trauma|traumata]] or on a single more significant injury, but in a large percentage of sufferers there is no obvious or remembered cause.  Other conditions that will cause pain and limitation of movement at the shoulder joint, include [[adhesive capsulitis]] and [[supraspinatus]] [[tendinitis]].
The cause of the condition is often unclear. It can in some cases be blamed either on repeated minor [[Physical trauma|traumata]] or on a single more significant injury, but in a large percentage of sufferers there is no obvious or remembered cause.  Other conditions that will cause pain and limitation of movement at the shoulder joint, include [[adhesive capsulitis]] and [[supraspinatus]] [[tendinitis]].
Subacromial bursitis must be differentiated from other causes of bursitis


==Signs and symptoms==
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
The presenting symptom is of pain in the shoulder on [[abduction]] of the arm, either actively or passively. Typically, movement at the shoulder either backwards or forwards in the [[sagittal plane]] causes little or no pain; rotation in either direction, however, is usually painful. The pain can be felt locally in and around the [[deltoid muscle]] or it may seem as if it is spreading down the arm towards the elbow. <ref>{{cite web|url=http://www.treatment-for.com/shoulder-bursitis-treatment.htm|title=Shoulder Bursitis}}</ref>, <ref>{{cite web|url=http://www.jointenterprise.co.uk/frozen-shoulder-4.htm|title=Pain around the shoulder}}</ref>
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Type of Bursitis}}
! style="background: #4479BA; width: 650px;" | {{fontcolor|#FFF|Differential diagnosis}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Subacromial bursitis]]'''<ref name=bursitis-upper-limb> Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[tendinitis|Rotator cuff tendinitis]]
*[[tendinitis|Supraspinatus tendinitis]]
*[[tendinitis|Bicipital tendinitis]]
*[[Frozen shoulder]] or [[adhesive capsulitis]]
*[[Rotator cuff|Rotator cuff tears]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Olecranon bursitis]]'''<ref name="pmid8894865">{{cite journal| author=Stell IM| title=Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management. | journal=J Accid Emerg Med | year= 1996 | volume= 13 | issue= 5 | pages= 351-3 | pmid=8894865 | doi= | pmc=1342774 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8894865  }} </ref><ref name="pmid21075998">{{cite journal| author=Lockman L| title=Treating nonseptic olecranon bursitis: a 3-step technique. | journal=Can Fam Physician | year= 2010 | volume= 56 | issue= 11 | pages= 1157 | pmid=21075998 | doi= | pmc=2980436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21075998  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Triceps]] [[tendinitis]]
*[[Olecranon]] spur
*[[Gout]] and [[Pseudogout]]
*[[Fracture]] of the [[ulna|olecranon process of the ulna]]
*Synovial cyst of the elbow joint
*[[Lipoma]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Trochanteric bursitis]]'''<ref name="pmid17880718">{{cite journal| author=Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW et al.| title=Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice. | journal=BMC Musculoskelet Disord | year= 2007 | volume= 8 | issue=  | pages= 95 | pmid=17880718 | doi=10.1186/1471-2474-8-95 | pmc=2045096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17880718  }} </ref><ref name="pmid4055877">{{cite journal| author=Karpinski MR, Piggott H| title=Greater trochanteric pain syndrome. A report of 15 cases. | journal=J Bone Joint Surg Br | year= 1985 | volume= 67 | issue= 5 | pages= 762-3 | pmid=4055877 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4055877  }} </ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
*Femur Injuries and [[fractures]]
*Femoral neck [[stress fracture]]
*Femoral head [[avascular necrosis]]
*[[Lumbar disk|Lumbar disk Problems]]
*[[Sacroiliac Joint]] Injury
*[[Hamstring|Hamstring Injury]]
*[[Iliopsoas]] [[tendinitis]]
*Lumbar and lumbosacral disk injuries
*Lumbosacral [[radiculopathy]]
*Lumbosacral spine strain or sprain
*[[Spondylolisthesis]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Prepatellar bursitis]]'''<ref name=Bursitis-four-types> Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.</ref><ref name=Prepatellar-Bursitis> Huang, Yu-Chih, and Wen-Lin Yeh. "Endoscopic treatment of prepatellar bursitis." International orthopaedics 35.3 (2011): 355-358.</ref><ref>Meyerding, Henry W., and ROBERT E. VanDEMARK. "POSTERIOR HERNIA OF THE KNEE:(BAKER'S CYST, POPLITEAL CYST, SEMIMEMBRANOSUS BURSITIS, MEDIAL GASTROCNEMIUS BURSITIS AND POPLITEAL BURSITIS)." Journal of the American Medical Association 122.13 (1943): 858-861.</ref>
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Meniscal tear]]
*[[osteonecrosis|Spontaneous osteonecrosis]]
*[[Tumor]]s
*Proximal tibia [[stress fracture]]
*[[Medial collateral ligament]] and [[Lateral collateral ligament|Lateral collateral Ligament Injury]]
*[[Posterior cruciate ligament|Posterior cruciate ligament injury]]
*[[Osteoarthritis]]
*[[Rheumatoid Arthritis|Rheumatoid Arthritis (RF)]]
*Pes Anserine Bursitis
*[[Baker's cyst]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Retrocalcaneal bursitis]]'''<ref name=Harrison-rheumatology> Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.</ref><ref name=Achilles-tendon> Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. "Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy." The American Journal of Sports Medicine 32.2 (2004): 457-461.</ref>  
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[tendonitis|Achilles tendonitis]]
*Posterior ankle impingment
*[[Haglund deformity]]
*Tendon rupture
*[[Plantar fasciitis]]
|}


==Diagnosis==
The presenting symptom is of pain in the shoulder on [[abduction]] of the arm, either actively or passively. Typically, movement at the shoulder either backwards or forwards in the [[sagittal plane]] causes little or no pain; rotation in either direction, however, is usually painful. The pain can be felt locally in and around the [[deltoid muscle]] or it may seem as if it is spreading down the arm towards the elbow.
==Treatment==
==Treatment==
The definitive, and curative, treatment is by injection of a hydrocortisone-type medication, ideally one which will remain active for a significantly long period of time, (a so-called ''depot'' injection) into the bursa. Orally administered or topically applied non-steroidal anti-inflammatory medications ([[NSAID]]s) will provide some degree of symptom relief, but will not provide a cure. As a number of other conditions will cause pain and limitation of movement at the shoulder joint, such as [[adhesive capsulitis]] and supraspinatus tendinitis, it is important to make an exact diagnosis, as a steroid injection into the wrong place will be wholly ineffective.
The definitive, and curative, treatment is by injection of a hydrocortisone-type medication, ideally one which will remain active for a significantly long period of time, (a so-called ''depot'' injection) into the bursa. Orally administered or topically applied non-steroidal anti-inflammatory medications ([[NSAID]]s) will provide some degree of symptom relief, but will not provide a cure. As a number of other conditions will cause pain and limitation of movement at the shoulder joint, such as [[adhesive capsulitis]] and supraspinatus tendinitis, it is important to make an exact diagnosis, as a steroid injection into the wrong place will be wholly ineffective.


==References==
==References==
<references/>
<references/>
 
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Latest revision as of 00:14, 19 September 2017

Subacromial bursitis
ICD-9 726.19

Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Subacromial bursitis is inflammation of the subacromial bursa, which lies between the acromion and the head of the humerus leading to extreme pain.

Differentiating Subacromial bursitis from other Diseases

The cause of the condition is often unclear. It can in some cases be blamed either on repeated minor traumata or on a single more significant injury, but in a large percentage of sufferers there is no obvious or remembered cause. Other conditions that will cause pain and limitation of movement at the shoulder joint, include adhesive capsulitis and supraspinatus tendinitis. Subacromial bursitis must be differentiated from other causes of bursitis

Type of Bursitis Differential diagnosis
Subacromial bursitis[1]
Olecranon bursitis[2][3]
Trochanteric bursitis[4][5]
Prepatellar bursitis[6][7][8]
Retrocalcaneal bursitis[9][10]

Diagnosis

The presenting symptom is of pain in the shoulder on abduction of the arm, either actively or passively. Typically, movement at the shoulder either backwards or forwards in the sagittal plane causes little or no pain; rotation in either direction, however, is usually painful. The pain can be felt locally in and around the deltoid muscle or it may seem as if it is spreading down the arm towards the elbow.

Treatment

The definitive, and curative, treatment is by injection of a hydrocortisone-type medication, ideally one which will remain active for a significantly long period of time, (a so-called depot injection) into the bursa. Orally administered or topically applied non-steroidal anti-inflammatory medications (NSAIDs) will provide some degree of symptom relief, but will not provide a cure. As a number of other conditions will cause pain and limitation of movement at the shoulder joint, such as adhesive capsulitis and supraspinatus tendinitis, it is important to make an exact diagnosis, as a steroid injection into the wrong place will be wholly ineffective.

References

  1. ↑ Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.
  2. ↑ Stell IM (1996). "Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management". J Accid Emerg Med. 13 (5): 351–3. PMC 1342774. PMID 8894865.
  3. ↑ Lockman L (2010). "Treating nonseptic olecranon bursitis: a 3-step technique". Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.
  4. ↑ Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW; et al. (2007). "Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice". BMC Musculoskelet Disord. 8: 95. doi:10.1186/1471-2474-8-95. PMC 2045096. PMID 17880718.
  5. ↑ Karpinski MR, Piggott H (1985). "Greater trochanteric pain syndrome. A report of 15 cases". J Bone Joint Surg Br. 67 (5): 762–3. PMID 4055877.
  6. ↑ Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.
  7. ↑ Huang, Yu-Chih, and Wen-Lin Yeh. "Endoscopic treatment of prepatellar bursitis." International orthopaedics 35.3 (2011): 355-358.
  8. ↑ Meyerding, Henry W., and ROBERT E. VanDEMARK. "POSTERIOR HERNIA OF THE KNEE:(BAKER'S CYST, POPLITEAL CYST, SEMIMEMBRANOSUS BURSITIS, MEDIAL GASTROCNEMIUS BURSITIS AND POPLITEAL BURSITIS)." Journal of the American Medical Association 122.13 (1943): 858-861.
  9. ↑ Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.
  10. ↑ Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. "Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy." The American Journal of Sports Medicine 32.2 (2004): 457-461.


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