Subcoracoid Bursa: Imaging Diagnosis and Significance

The aim of this study was to retrospectively evaluate the cases in which a subcoracoid bursa had been detected using various imaging tools, to discuss imaging features among the different modalities, and to correlate our findings with those of associated shoulder joint disorders. In total, 23 cases of subcoracoid bursa diagnosed imaging studies were retrospectively analyzed. Five of these cases underwent bursography, among which four were inadvertently performed and one was a planned bursogram. Three cases underwent an arthrogram, one was a shoulder arthrogram alone, one was an immediate arthrogram performed after an inadvertent bursogram, and the other one was a follow-up arthrogram performed one month later after an inadvertent bursogram. Three of the cases underwent CT bursography, and all had first undergone subcoracoid bursography. Twenty-one of these cases underwent MRI, and six of these had undergone MR arthrography for the routine evaluation of internal derangements involving the glenohumeral joint. Eleven cases had undergone two or more than two separate imaging studies. In 18 cases, subcoracoid bursa communication with the subacromial–subdeltoid bursa was observed (18/23, 78.3%), and a rotator cuff tear was present in 17 of these 18 cases. A complete rotator cuff tear was present in a total of 18 cases; 16 involved an anterior supraspinatus tendon tear, and two involved tear of the posterior portion of the supraspinatus or infraspinatus tendon tear. Communication between the subcoracoid bursa and subacromial–subdletoid bursa was demonstrated in 17 of the 18 cases with a complete rotator cuff tear. However, none of the cases exhibited communication between the subcoracoid bursa and the glenohumeral joint. If an inadvertent subcoracoid bursography is performed, contrast medium may fill the subacromial–subdeltoid bursa via a potential communication. Delayed, post-exercise imaging or repeated arthrography is necessary to ascertain the presence or absence of a rotator cuff tear. On MRI, MR arthrography, and CT bursography, the condition of the rotator cuff must be carefully assessed if subcoracoid bursal distention is present. Correspondence Author to: Clement Kuen-Huang Chen Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan No. 901, Zhong-Hua Road, Yong-Kang, Tainan 710, Taiwan J radiol sci 2013; 38: 111-118