Which bursae that are most commonly affected by bursitis?

Updated: Dec 11, 2020
  • Author: Kristine M Lohr, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

All of the approximately 160 bursae in the human body are potentially susceptible to injury. The three upper-extremity bursae that are most commonly affected by bursitis are the subacromial, subscapular, and olecranon bursae. [4]

The subacromial bursa separates the superior surface of the supraspinatus tendon from the overlying coracoacromial arch and the deltoid muscle. It lies between the acromion and the rotator cuff and cushions the coracoacromial ligament from the supraspinatus muscle. When the arm is resting at the side, the bursa protrudes laterally from beneath the acromion; when the arm is abducted, it rolls medially beneath the bone. See the image below.

Subscapular bursae are found between the anterior surface of the scapula and the posterior chest wall. The 2 commonly affected bursae are located superomedially between the serratus anterior and the chest wall. See the image below.

Shoulder anatomy muscle, anterior view. Shoulder anatomy muscle, anterior view.

Two olecranon bursae can become inflamed; one lies between the tendon of the triceps and the posterior ligament of the elbow and the olecranon, whereas the other is more superficial, lying between the attachment of the triceps to the olecranon and the skin.

Various lower-extremity bursae can also be affected by bursitis. The ones most commonly involved are in the hip, the knee, and the ankle. [5, 6, 7]

In the hip, the ischiogluteal bursa lies deep to the gluteus maximus over the ischial tuberosity. The iliopsoas bursa, the largest bursa in the body, lies between the iliopsoas tendon and the lesser trochanter, extending upward into the iliac fossa beneath the iliacus. The trochanteric bursa has superficial and deep components, with the superficial bursa lying between the tensor fascia latae and the skin and the deep bursa located between the greater trochanter and the tensor fasciae latae.

In the knee, bursae commonly affected by bursitis include the medial collateral ligament bursa, the anserine (pes anserinus) bursa (see the image below), the prepatellar bursa (located anteriorly over the patella, between patella and skin), the infrapatellar bursa (containing a superficial component lying between the patellar ligament and the skin and a deep component lying between the patellar ligament and the proximal anterior tibia), and the popliteal bursae, or Baker cysts (located in the posterior joint capsule of the knee). [6]

Location of anserine (pes anserinus) bursa on medi Location of anserine (pes anserinus) bursa on medial knee. MCL=medial collateral ligament.

In the ankle, two bursae are found at the level of insertion of the Achilles tendon. The superficial one is located between the skin and the tendon, and the deep one is located between the calcaneus and the tendon. The latter is the one more commonly affected by bursitis.


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