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
-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)