38-year-old patient presenting with shoulder pain, likely aggravated by elevation, reaching, or side-lying.
Ultrasound examination of the shoulder demonstrates mild distension and thickening of the subacromial-subdeltoid (SASD) bursa, consistent with mild bursitis.
No additional structural abnormalities have been specified in the current dataset.
Mild SASD bursitis may be reactive, secondary to overuse, altered shoulder mechanics, impingement, or adjacent rotator cuff pathology.
1. Final diagnosis
Mild subacromial-subdeltoid bursitis.
2. Differential diagnosis
Consider reactive bursitis secondary to impingement or subtle rotator cuff tendinopathy. Clinical correlation is recommended.
3. Teaching points
Even mild bursal thickening may be symptomatic, particularly during abduction or side-lying. The SASD bursa is a common pain generator in subacromial pain syndrome.
4. Injury/disease information
Subacromial-subdeltoid bursitis involves irritation or inflammation of the bursa between the rotator cuff and deltoid/acromion complex. It may occur in isolation or together with tendon overload and shoulder impingement.
Marc is founder of, and trainer at, SonoSkills. SonoSkills is an organization dedicated to MSK ultrasound education. He's also an MSK Sonographer at EchoConsult in Roermond, the Netherlands.
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