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Thickened Subacromial Bursa

A previously unrecognized form of rotator cuff injury can occur in contact sports. After an acute traumatic injury to the shoulder, the athlete may develop weakness on elevation and external rotation. The clinical symptoms are the same as for a torn rotator cuff. An MRI reveals only hypertrophic changes (enlargement and thickening) on the bursal side of the cuff. Symptoms may persist despite rehabilitation.
These patients can be treated arthroscopically. Diffuse proliferation of the subacromial bursa may be noted. After resection of the hypertrophic bursa the athlete tends to rapidly improve. This syndrome should be considered in an athlete with persistent cuff pain and weakness who participates in contact sports.

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