Subcoracoid-Subscapularis Bursa MRI

35 yr old male with pain  and 64 yr old  with degeneration and rotator cuff tear.  MRIs displayed together  for differentiating between the  subcoracoid bursal fluid (64yrs) and superior subscapularis  recess fluid (35 yrs)

Teaching points by Dr MGK Murthy

(A)subcoracoid bursa

-between subscapularis and  coracoid process.

-extends caudally to tendon of coracobrachialis and short head biceps

- does not normally communicate with the glenohumeral joint

- Fluid here is invariably pathological eg: bursal / other causes

-associated with Rotator cuff tears

(B) superior subscapularis recess also known as the subscapularis bursa.

-recess of the  glenohumeral joint capsule projecting anteriorly between SGHL and MGHL

-saddlebag appearance created by hanging over the subscapularis  tendon

- size varies inversely with MGHL(larger the MGHL, smaller is the recess)

- fluid here can mimic subcoracoid bursal fluid , because it extends to ant surface of subscapularis tendon

-fluid here could be simply normal joint fluid

(C) Inferior subscapularis recess exists between MGHL and IGHL(inferiorly)