subacromial bursitis
Introduction
Introduction to acromion sac The scapula sac, also known as the deltoid sac, is one of the largest sacs in the body. It is located below the shoulder, the sacral ligament and the deep fascia of the deltoid, above the rotator cuff and the greater sacral nodule, and the shoulder abduction When the internal rotation is performed, the sac slides into the lower part of the shoulder with the large nodule of the humerus, and cannot be touched. The scapula of the shoulder has many protrusions to protrude into the lower part of the shoulder. In addition, the capsule attached to the supraspinatus muscle has a smaller sac, and the free margin is larger, which is beneficial to the movement of the shoulder. Therefore, the scapula of the shoulder is important for the movement of the shoulder joint, and is called the second shoulder. joint. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: elbow joint stiffness and fibrous stiffness
Cause
Cause of acromion scaphoid
Shoulder joint disease (40%)
Most cases are secondary to the injury and degeneration of the tissues surrounding the shoulder joint, especially the injury of the supraspinatus tendon at the base of the bursa. Degenerative changes are more common, because the supraspinatus tendon is at the bottom of the acromial sac. When acute and chronic injury occurs in the supraspinatus muscle, the sac is also damaged, which leads to non-specific inflammation of the shoulder-slung sac.
Physical factors (15%)
The acromial sac is also known as the deltoid sac. It is divided into two parts: the subacromial and the deltoid. There may be a thin septum between the two, but most of them are connected. The bursa will be the greater sacral and deltoid muscles. The shoulders are separated. Due to injury or long-term compression, mechanical and other physical stimulation, the sac is caused by congestion, edema, exudation, hyperplasia, hypertrophy, adhesion and other aseptic inflammatory reactions.
Calcium salt deposition (10%)
Calcium deposits of the supraspinatus tendon penetrate the bursa and are also one of the causes of acromion sac.
Other factors (10%)
Diseases such as rheumatism, tuberculosis, and gout can also induce the disease to some extent.
Prevention
Shoulder sac bursitis prevention
May be caused by direct or indirect trauma, supraspinatus tendon injury or degeneration, long-term compression and stimulation. Such as falling, falling, and emergency braking caused by the car. Therefore, pay attention to living habits, high-risk workers, such as construction workers, mining workers, and teachers and workers are likely to cause damage, and should pay attention to protect themselves during the work process. Pay attention to calmness and avoid emotional conflicts leading to the disease. Secondly, early detection, early diagnosis and early treatment are also important for the prevention of this disease.
Complication
Acromegaly bursitis complications Complications elbow joint stiffness and fibrous stiffness
Severe cases can be complicated with fibrous shoulder stiffness.
Symptom
Acromion sac inflammatory symptoms common symptoms cyst nodules muscle atrophy
General symptoms
Pain, limited exercise and localized tenderness are the main symptoms of acromion scrotum. The pain is gradually worsened, the pain at night is higher, and the pain is increased during exercise, especially during abduction and external rotation (squeezing bursa). Located in the depths of the shoulders, involving the dead ends of the deltoid muscles, etc., can also be radiated to the scapula, neck and hands.
2. Local symptoms
Check for tender points in the shoulder joint, under the shoulder, big nodules, etc., which can be displaced with the rotation of the humerus. When the sac is swollen and effusion, there is tenderness in the entire shoulder joint area and the deltoid muscle to relieve pain. The patient often puts the shoulder joint in the adduction and internal rotation to reduce the squeezing stimulation of the bursa. With the thickening and adhesion of the sac wall, the range of motion of the shoulder joint is gradually reduced to completely disappear, and the scapula can be seen in the late stage. Muscle atrophy.
Examine
Examination of acromion bursitis
1. Tenderness: There is obvious localized tenderness at the lateral shoulder and the large nodules on the lateral shoulder joint.
2. Swelling: In the acute phase, due to congestion and edema of the bursa, the swollen sac can be touched in front of the shoulder joint. In the chronic phase, the lateral aspect of the shoulder can be touched with nodular positives.
3, dysfunction: dysfunction in the acute phase is mostly caused by pain, dysfunction in the chronic phase is mostly due to the gradual inflammation and thickening of the sac wall and adhesion to the sleeve. Especially the exhibition, the external rotation is even worse.
4, muscle atrophy: early appearance of the upper muscle, the infraorbital muscle atrophy, late deltoid muscle atrophy.
5, x-ray examination, early shoulder joints are mostly negative, in the late stage, there is calcium deposits in the supraspinatus tendon.
Diagnosis
Diagnosis and identification of acromion scapulositis
diagnosis
The main feature of this disease is deep pain in the lateral side of the shoulder, and radiation to the deltoid point. The limitation of the shoulder joint is abduction and external rotation. Combined with the relevant examination, the diagnosis can be confirmed.
Differential diagnosis
Pay attention to the identification of the following diseases:
Ulnar muscle tendinitis: the pain site is at the anterior aspect of the anterior superior sacral muscle, and the pain axis of the shoulder joint abduction (60 degrees to 120 degrees) is an important basis for the diagnosis of this disease.
Long head tenosynovitis of the biceps muscle: the pain is localized in the anterior tibial tuberosity. A small number of patients can access the cord. The shoulder joint internal rotation test and the resistance test were positive.
