The subacromial-subdeltoid bursa (SASD), also simply known as the subacromial bursa, is a bursa within the shoulder that is simply a potential space in normal individuals.
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Gross anatomy
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found deep to the deltoid muscle and the coraco-acromial arch
medially in close relation to the acromio-clavicular joint
the mid-point of the bursa commonly corresponds to the most anterior extent of the acromion
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extends laterally over the greater tuberosity of the humerus, terminating in its sub-deltoid reflection an average of 4 cm from the mid-point of the acromion
this osseous landmark also corresponds to the posterior bursal reflection
envelops the bicipital groove as it extends inferiorly
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superficial anatomic relations include the rotator interval and the supraspinatus tendon
invested by parallel layers of peri-bursal fat
relationship with supraspinatus tendon consistent, whereas it may or may not interface with the infraspinatus
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anatomically discontinuous with the gleno-humeral joint
communication may occur in the presence of rotator cuff pathology
Radiographic features
Ultrasound
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the hyperechoic peri-bursal fat forms a prominent interface between the deltoid and/or acromion and the underlying supraspinatus allowing identification of the potential space representing the bursa
anechoic fluid may interpose between the layers of peri-bursal fat forming a tri-laminar interface
bursal thickness is typically less than 1 mm in the presence of physiologic amounts of bursal fluid
color flow Doppler examination should reveal an absence of bursal vascularity
dynamic visualization during shoulder abduction and adduction should demonstrate smooth translocation of the bursal reflection beneath the acromion
Related pathology
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bursitis
septic bursitis
rheumatoid arthritis
