Subcutaneous Acromial Bursa

bursa acromialis subcutanea

The subcutaneous acromial bursa lies between the acromion tip and the overlying skin at the lateral shoulder, distinct from the subacromial bursa which is deep to the deltoid. It can become inflamed from direct, repeated pressure, such as backpack or rucksack straps, shoulder pads, carrying loads on the shoulder, or prolonged lying on that side. The subacromial bursa is the clinically significant bursa for shoulder impingement; the subcutaneous acromial bursa is a minor structure.

Anatomical Data

Location

Location	Between the skin and the acromion process at the lateral shoulder point
Nearby	Acromion tip Overlying deltoid skin

Biomechanics

Function & Actions

Reduces friction between the skin and the bony acromion prominence during arm movements

Clinical Relevance

Clinical Notes

Subcutaneous acromial bursitis presents as a soft, fluctuant swelling directly over the acromion tip and is seen in soldiers, labourers who carry loads on the shoulder, and contact sport athletes. It must be distinguished from subacromial bursitis by its superficial location and provocation by direct pressure rather than arm movement. Padding, pressure relief, and aspiration resolve most cases. Septic bursitis is rare but requires aspiration for culture and may need surgical drainage.

Pathology

Common Injuries & Conditions

Subcutaneous Acromial Bursitis

Pressure bursitis over the acromion tip from repeated strap, pad or load pressure, producing a soft superficial lump and lateral shoulder tenderness, managed with padding, activity modification and aspiration.

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