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Subcoracoid bursitis
The subcoracoid bursitis in much less frequent than the chronic subdeltoid bursitis. The clinical image is very clear. It reacts well on infiltration.
The patient experiences intermittent pectoral pain, mostly related to certain activities. The onset is spontaneous.
Also here, the passive lateral rotation is limited, but because of pain, the structures which are stretched on passive lateral rotation exert pressure on the inflamed bursa.
The treatment is an infiltration of triamcinolone.
How can we differentiate between anterior capsular adhesions and a subcorcacoid bursitis ?
Starting position : when the passive lateral rotation is performed from 90° of abduction, much less pressure is exerted upon the bursa, so the movement is less limited in bursitis. In the case of a capsular contracture it stays unaltered.
End-feel : elastic in a bursitis, harder in a capsular contracture.
Passive horizontal adduction : is markedly positive in bursitis, not in capsular contracture.
(part I, p39-40)
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