The Treatment of Acute Subacromial Bursitis

Abstract

The onset of acute subacromial bursitis often is sudden. There may be a short prodromal period of soreness and aching in the shoulder, but the acute symptoms frequently develop within a period of a few hours. Preceding the onset of the symptoms may be a history of an injury to the shoulder, which may be insignificant or in the nature of a sudden twist or jerk. There may be no immediate pain, but soon after the injury symptoms of an acute subacromial bursitis may develop.

Pain and disability in the shoulder are the outstanding symptoms. The pain is acute and localized to the region of the anterolateral aspect of the shoulder, and often radiates to the side of the neck and region of the attachment of the deltoid muscle. There usually is marked restriction of motion in abduction and in internal and external rotation. Movements are restricted by marked muscle spasm and are associated with acute pain. A limited degree of painless flexion and extension usually is possible. Palpation reveals invariable tenderness over the subacromial region or over the greater tuberosity of the humerus. Occasionally the bursa may be distended.

Subacromial bursitis may occur as an acute serous bursitis or there may be flocculent calcific deposits in the bursa. I have observed several cases in which an acute process developed in a chronic case in which roentgenograms showed a dense calcific deposit in the bursa. This type of case responds well to aspiration and irrigation, but return to normal function. . .