LAUSR

Shoulder pain is a common musculoskeletal disorder in the general population, and the causes are variable, ranging from inflammatory to mechanical disorders. Currently, ultrasound (US) imaging is an established tool to promptly optimize the diagnosis and guide interventions in its management. Among others, the subacromial-subdeltoid (SASD) bursa is considered one of the primary pain-generating tissues in the shoulder, and bursopathy is the most commonly reported finding on diagnostic US imaging in patients with shoulder disorders. The SASD bursa is located superficial to the rotator cuff, below the deltoid muscle and the coracoacromial arch. It is a large synovial structure extending from the subcoracoid space medially to the subdeltoid space laterally. The mechanoreceptors and nociceptors located in the bursal subsynovial connective tissue can activate the reflex arc of the suprascapular and axillary nerves. In this sense, the anatomic distribution of SASD bursa-related (localized to widespread) pain can be highly variable. The physiologic function of this bursa is guaranteed by the regular gliding between the two synovial layers and the peribursal (extrasynovial) fat, a layer of adipose tissue contiguous with the intermuscular fat located between the rotator cuff and the surrounding muscles. Regarding the terminology commonly used in clinical practice, the word “bursitis” has completely replaced the word “bursopathy,” as if the pathologic mechanism of this bursa in the shoulder (and in general in musculoskeletal medicine) were Video online at jultrasoundmed.org