QuestionSBA
QuestionChoice
Glenohumeral instability results in recurrent subluxation or dislocation of the shoulder joint. It is typically found in young, athletic individuals, or individuals with hypermobility disorders. Patients are unable to maintain the humeral head within the glenoid fossa, so they hold their arm close to their body with the unaffected hand to compensate for instability. They do not present with pain on shoulder abduction, unless there was dislocation during the movement.
53161
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Glenohumeral instability
QuestionChoice
Patients with biceps teninditis present with acute, intense pain at the anterior aspect of the shoulder. On examination, you would expect to find tenderness when palpating the biceps tendon which becomes worse with supination of the forearm and elbow flexion, rather than shoulder abduction.
53159
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Biceps tendinitis
QuestionChoice
This is incorrect because cervical radiculopathy usually presents with radicular, nerve-type pain (i.e. shooting or tingling down the arm), and myotomal/dermatomal loss of function. There may be associated neck pain due to osteoarthritis, which may be the cause of the radiculopathy. There may be loss of tendon reflexes. This patient has a normal neurovascular examination and no evidence of myotomal/dermatomal loss of function, nor nerve-type pain.
53160
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Cervical radiculopathy
QuestionChoice
This is correct because this patient describes symptoms of pain in her shoulder with a history of repetitive overhead activities. Pain with active abduction of the shoulder at 60-120 degrees with reduced range of motion is typical for subacromial bursitis. This is due to an inflamed bursa which separates the supraspinatus tendon from the acromial arch and deltoid muscle. This is a clinical diagnosis and first line management is rest with NSAIDs. Steroid injections are sometimes also considered.
53157
a
Subacromial bursitis
QuestionChoice
Adhesive capsulitis is also know as frozen shoulder syndrome as there is inflammation of the glenohumeral joint causing restricted passive and active shoulder movements in all directions. It is usually associated with other conditions such as diabetes mellitus, thyroid disease, rheumatoid arthritis, or recent immobility (for example after surgery or a fracture.) Patients typically have a more chronic course, presenting with shoulder pain followed by freezing (over 6-9 weeks), and then gradual recovery over months. This patient has a relatively acute presentation, and her range of movement is not restricted in all directions. She does not have any of the typical risk factors associated with frozen shoulder syndrome, either.
53158
b
Adhesive capsulitis
QuestionComment
wouldn't you be able to see a bursa?
24107
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NICU Fever
QuestionComment
how would you differentiate this from a supraspinatus tear?
36968
QuestionComment
tear = weakness, bursitis = pain without weakness?
58225
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moins que
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Amnesia Syndrome
Concept
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# Summary

Subacromial bursitis is an inflammatory condition often linked to shoulder pain. Key signs and symptoms include shoulder pain, reduced range of motion, and tenderness over the shoulder joint. It's usually caused by repetitive overhead activities, minor trauma, subacromial impingement, and other multifactorial causes. Key investigations include routine blood tests, shoulder X-ray, and MRI. Management predominantly involves nonoperative treatment methods such as rest, NSAIDs, physical therapy, and corticosteroid injections.

# Definition

Subacromial bursitis refers to an inflammatory condition of the subacromial bursa, a small fluid-filled sac located between the acromion (part of the shoulder blade that forms the top of the shoulder) and the rotator cuff. This condition often results in shoulder pain.

# Epidemiology

Subacromial bursitis is commonly seen in both athletic populations and sedentary individuals. Its prevalence tends to increase with age and is more common in those engaged in activities involving repetitive overhead arm movements.

# Aetiology

The aetiology of subacromial bursitis can be multifactorial, often attributed to:

-   Subacromial impingement
-   Repetitive overhead activities or overuse of the shoulder joint
-   Direct trauma such as falls
-   Crystal deposition diseases
-   Subacromial haemorrhage
-   Infection
-   Autoimmune diseases, such as rheumatoid arthritis

# Signs and Symptoms

The typical signs and symptoms of subacromial bursitis include:

-   Pain in the shoulder, often worsening with overhead activities
-   Reduced range of motion
-   Tenderness over the shoulder joint
-   Possible swelling and redness in severe cases"

# Differential Diagnosis

In the differential diagnosis of subacromial bursitis, the following conditions should be considered, which present with similar signs and symptoms:

-   Rotator cuff tendinopathy: Presents with shoulder pain, difficulty lifting objects, and reduced range of motion.
-   Adhesive capsulitis (Frozen shoulder): Characterized by stiffness, pain, and limited range of motion in the shoulder.
-   Shoulder osteoarthritis: Manifests as gradual shoulder pain, stiffness, and restricted movement.
-   Glenohumeral joint instability: Results in shoulder pain, a sensation of the shoulder giving way, and reduced shoulder function.

# Investigations

The investigation of subacromial bursitis typically involves:

-   Routine Blood Tests: To rule out systemic causes such as infection or rheumatoid arthritis.
-   Shoulder X-ray: To evaluate for bone abnormalities and changes in joint space.
-   Shoulder MRI: To assess soft tissue structures, including the bursa and rotator cuff.

# Management

The management of subacromial bursitis generally involves nonoperative treatment modalities, which include:

-   Rest: To allow the inflammation to subside.
-   Non-steroidal anti-inflammatory medications (NSAIDs): To manage pain and reduce inflammation.
-   Physical therapy: To improve range of motion and strengthen shoulder muscles.
-   Corticosteroid injections: For severe cases where pain and inflammation are not managed with the above treatments.
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Subacromial bursitis
Topic
37
Orthopaedics
Condition
121
Bursitis
UkmlaTopic
16
Musculoskeletal
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Subacromial bursitis presents with shoulder pain during active abduction, often linked to repetitive overhead activities and relieved by rest and NSAIDs.
Presentation
150
Chronic joint pain/stiffness
UkmlaTopic
16
Musculoskeletal
A 45-year-old woman presents to the GP with pain in her left shoulder. She says this has been going on for the past 3 weeks and is limiting her ability to work. She works for a food packaging company and has to move heavy boxes and stack tall shelves as part of her job. She has no significant past medical history. On examination, there is tenderness at the anterolateral aspect of her left shoulder. There is pain with active abduction of the arm at 90 degrees, limiting further abduction. There is a good range of movement elsewhere. Except for weakness attributed to pain, neurovascular examination of the upper limb is normal.

Which of the following is the most likely diagnosis?
a