In this case it was not classical bursitis, but rather parabursitis. Accidentally we met a patient of the orthopaedic outpatient department who was repeatedly aspirated with a dg. of subdeltoid bursitis. At the time we saw him, he was after the seventh artrocentesis. At each of them about 30 ml of a liquid was aspirated.

Objective Finding on the Shoulder

A pronounced bulging in the area of the glenohumeral articulation, with a fluctuation corresponding to bursitis.

Ultrasound Examination

It showed not only subdeltoid bursitis, but also a liquid under the rotator cuff. The rotator cuff swam in the liquid. But the liquid was surprisingly found in the area of the second shoulder even if in less amount (unfortunately patient's ultrasound documentation was lost in the orthopaedic department).


Albumin in serum 22 g/1, proteinuria ++++

Internal  Consilium

It found a symmetrical effusion of lower limbs, the patient is with probable symptoms of serious hypo-albumunaemia at nefrotic syndrome. The patient was sent to the metabolic department where he died after 10 days. The cause of the nefrotic syndrome was not found.


hypo-albuminaemic parabursitis in the area of the shoulder girdle


Also hypo-albuminaemia can be manifested by an extent transudate in the area of the glenohumeral articulation which reminds bursitis.