Range of normal and abnormal subacromial/subdeltoid bursa fluid.
OBJECTIVE
To determine the range of normal and abnormal subacromial/subdeltoid (SA/SD) bursa fluid.


METHODS
Using a 1.5-T magnetic resonance (MR) imaging scanner, 2 observers evaluated coronal oblique T2-weighted, fast spin echo, fat-suppressed images of 71 persons (36 asymptomatic volunteers and 35 patients with full-thickness rotator cuff tears [RCTs]) for the 1) widest thickness of the SA/SD bursa; 2) medial extent of bursa from the acromioclavicular joint (ACJ); and 3) because patients were supine, whether fluid was in the posterior quarter, middle quarter, anterior quarter, or anterior-most quarter of the bursa.


RESULTS
The range of bursa thickness was 0 to 7 mm (mean = 1.3 mm, median = 2 mm) in normal bursas and 0 to 8 mm (mean = 3.3 mm, median = 3 mm; P < 0.05, t test) in RCTs. Only 2 volunteers exceeded 3 mm in bursa thickness. In volunteers, 36% had no fluid present, 61% had a small amount of fluid lateral to the ACJ, and 1 had fluid directly beneath the ACJ (P < 0.05). In RCT patients, 37% had fluid directly under the ACJ or medial to the ACJ. Only 1 patient with an RCT had no bursal fluid. In volunteers, most fluid was in the posterior quarter (53%) or middle quarter (22%) of the bursa, whereas in RCT patients, most fluid was located in the anterior quarter of the humerus or anterior to the humerus (89%; P < 0.05).


CONCLUSIONS
Normal SA/SD bursa fluid is rarely thicker than 2 mm and tends to be located posteriorly. An abnormal amount of fluid is present when the thickness exceeds 3 mm, fluid is present medial to the ACJ, and fluid is seen in the part of the bursa anterior to the humerus.
White
Eric A
EA
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA. ericallanwhite@yahoo.com
Schweitzer
Mark E
ME
Haims
Andrew H
AH
D000293:Adolescent; D000328:Adult; D002062:Bursitis / Q000175:diagnosis*; D016022:Case-Control Studies; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries; D013582:Synovial Fluid