Does the subacromial bursa communicate with the rotator cuff tendons?

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From the Guidelines

No, the subacromial bursa does not normally communicate with the rotator cuff tendons.

Key Points

  • The subacromial bursa and rotator cuff tendons are separate structures that do not typically communicate with each other under normal conditions 1.
  • However, in cases of rotator cuff tears or inflammation, a communication between the subacromial bursa and the tendon can occur, allowing for the exchange of fluid and potentially irritating substances.
  • MRI can aid in detecting soft tissue abnormalities, including those in the supraspinatus tendon, subacromial bursa, and biceps tendon, which can help identify potential communications between these structures 1.
  • Partial-thickness tears of the rotator cuff can be seen inferiorly at the articular surface, superiorly at the bursal surface or within the tendon substance, and may be associated with communication between the subacromial bursa and the tendon 1.
  • Full-thickness tears of the rotator cuff tendon can be accurately identified using conventional nonarthrographic MRI, with high sensitivity and specificity, and may also be associated with communication between the subacromial bursa and the tendon 1.

From the Research

Subacromial Bursa and Rotator Cuff Tendons Communication

  • The subacromial bursa does not directly communicate with the rotator cuff tendons in normal anatomical conditions 2.
  • However, in cases of rotator cuff tears, the subacromial bursa may occasionally communicate with the subacromial-subdeltoid bursa, which is located near the rotator cuff tendons 2.
  • The interaction between the subacromial bursa and rotator cuff tendons is complex, and studies have shown that the bursa plays a role in the pathology of rotator cuff tendinopathies, with proliferative or degenerative changes occurring in the bursa in response to rotator cuff tears 3.
  • The blood supply to the subacromial bursa and rotator cuff tendons on the bursal side is provided by several arteries, including the thoracoacromial, suprascapular, and anterior and posterior circumflex humeral arteries 4.

Clinical and Histopathological Features

  • Studies have shown that the subacromial bursa and rotator cuff tendons exhibit histopathological changes, such as hypertrophy, inflammation, and necrosis, in response to rotator cuff tears 5.
  • These changes are associated with pain and may play a role in the generation of pain in patients with rotator cuff tears 5.
  • The subacromial bursa may also play a role in the healing process of rotator cuff tears, and its interaction with the rotator cuff tendons is an important area of study 6, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Findings of the subcoracoid bursa on MR arthrography and their clinical significance].

Nihon Igaku Hoshasen Gakkai zasshi. Nippon acta radiologica, 2002

Research

Ultrastructure of the subacromial bursa in painful shoulder syndromes.

Virchows Archiv. A, Pathological anatomy and histopathology, 1983

Research

Blood supply of the subacromial bursa and rotator cuff tendons on the bursal side.

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017

Research

The role of tendon and subacromial bursa in rotator cuff tear pain: a clinical and histopathological study.

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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