Subacromial Bursa

bursa subacromialis

The subacromial bursa is the largest bursa in the body, lying between the rotator cuff (primarily supraspinatus) and the coracoacromial arch (acromion, coracoacromial ligament, and acromioclavicular joint). It does not normally communicate with the glenohumeral joint but does so when a full-thickness rotator cuff tear is present, allowing joint fluid to enter the bursa.

Region: Shoulder

Clinical Relevance

Clinical Notes

Subacromial bursitis is the most common cause of shoulder pain in primary care, producing a painful arc from 60-120 degrees of abduction. Ultrasound demonstrates bursal thickening, fluid, and associated rotator cuff pathology. Corticosteroid injection into the subacromial space is both diagnostic and therapeutic. Subacromial impingement from reduced acromiohumeral distance compresses the bursa. Communication between the glenohumeral joint and subacromial bursa on arthrography confirms full-thickness rotator cuff tear. Arthroscopic subacromial decompression removes the inflamed bursa and may include acromioplasty.

Pathology

Common Injuries & Conditions

Subacromial Bursitis

Inflammation from rotator cuff impingement or overuse, producing a painful arc of abduction and tenderness beneath the acromion — often coexisting with rotator cuff tendinopathy.