Atypical Localization of Bursae

Bursitides most frequently occur in the subdeltoid area in the area of the tendon of the long head of the biceps. But they  occur anywhere in the area of the whole limb, and there the ultrasound examination can bring positive diagnosis. From quite atypical localizations we are going to show bursitis hidden in the zero position of the limb between the processus coracoideus and m. subscapularis, so it is recognizable only at a maximal outer rotation of the limb. Only in this position its content could be aspirated, and an only steroid peritendinous injection relieved the patient's pains. Before that she had extreme pains of the shoulder for 3 months watched in the orthopaedic outpatient department, with 4 steroid peritendinous injections without any relief.

 

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picture and scheme of the atypical localization of bursae hidden in the zero position of the shoulder under the processus coracoideus

videoclip of the bursa hidden in the zero position of the shoulder under the processus coracoideus


Commentary

Atypical localization of bursae relativise our effort for the untargetable aspiration, or peritendinous injections of these structures because it is not possible to behave to them according to any instructions. Also at untargetable aspirations there is a possibility of a damage of other structures.