Subacromial bursitis

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	Rotator cuff tendinitis Supraspinatus tendinitis Bicipital tendinitis Frozen shoulder or adhesive capsulitis Rotator cuff tears
Olecranon bursitis	Triceps tendinitis Olecranon spur Gout and Pseudogout Fracture of the olecranon process of the ulna Synovial cyst of the elbow joint Lipoma
Trochanteric bursitis	Femur Injuries and fractures Femoral neck stress fracture Femoral head avascular necrosis Lumbar disk Problems Sacroiliac Joint Injury Hamstring Injury Iliopsoas tendinitis Lumbar and lumbosacral disk injuries Lumbosacral radiculopathy Lumbosacral spine strain or sprain Spondylolisthesis
Prepatellar bursitis	Meniscal tear Spontaneous osteonecrosis Tumors Proximal tibia stress fracture Medial collateral ligament and Lateral collateral Ligament Injury Posterior cruciate ligament injury Osteoarthritis Rheumatoid Arthritis (RF) Pes Anserine Bursitis Baker's cyst
Retrocalcaneal bursitis	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

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.