NBME 23 Subacromial bursitis (NBME Answers)

Retired NBME 23 Answers

nbme23/Block 4/Question#2 (reveal difficulty score)
A 60-year-old woman with type 2 diabetes ...
Subacromial bursitis 🔍 / 📺 / 🌳 / 📖
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submitted by doomarion(3)

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Subacromial bursitis = Nocturnal Exacerbation of pain, pain overhead, pain between deltoid and AC joint

No impingement = not rotator cuff tendinitis

Like Hayayah said "adhesive capsulitis causes severe restriction of both active and passive range of movement of the glenohumeral joint in all planes "

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pamelalimlf Not sure how true but wiki says that there can be positive impingement sign in subacromial bursitis. Aside from the above, is there any other specific symptoms we can look out for to confirm it is subacromial bursitis? (: https://en.wikipedia.org/wiki/Subacromial_bursitis +1

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submitted by ∗d_holles(218)

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https://www.amboss.com/us/knowledge/Soft_tissue_lesions_of_the_shoulder

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yex There is a Q on UWorld about rotator cuff tendinitis #380186 w/ a similar presentation... I kind of remembered about that, but honestly I do not know how I got it right. +

yex Correction: Q id is # 1732 +

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submitted by ∗huszagmc(5)

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Bursitis tends to cause pain both during movement and at rest (e.g. simply laying on your shoulder is painful), while tendonitis only causes pain while you are actively using the muscle of the inflamed tendon. This expands on @doomarion's comment! Note for both, though, that you can have point tenderness since you are actively putting pressure where there is inflammation...

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submitted by docred123(9)

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Why is the answer to this question not Adhesivie Capsultiis...

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hayayah Adhesive capsulitis causes severe restriction of both active and passive range of movement of the glenohumeral joint in all planes (especially external rotation). +25

catch-22 Adhesive capsulitis is aka "frozen shouder" so you can expect exactly that. The entire shoulder will be hard to move in all directions. +6

meningitis Since it says there is NO impingement sign, it cant be rotator cuff tendinitis correct? What other signs eliminate this option? +1

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submitted by ∗hello(429)

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Why are "rotator cuff tear" and "rotator cuff tendnitis" wrong? is it bc both of these would show impingement sign? is there a way to DDx one from the other?

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snripper It can't be rotator cuff problems because abduction is normal up to 90 degrees. +2

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submitted by clamshell27(0)

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Can anyone explain why bicipital tendonitis is incorrect?

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shieldmaiden Tendonitis from this tendon will have point tenderness on the anterior side of the joint or closer to the coracoid process. Inflammation is usually caused by impingement (@bicipital groove), which it says here there isn't +1

leemax for U guys! https://www.amboss.com/us/knowledge/Soft_tissue_lesions_of_the_shoulder +

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