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Triathlete struggling to swim crawl. Night pain side lying.

OE - Plenty of ‘subacromial’ signs.

POCUS - huge bursal effusion with hyperechogenic frond-like material throughout sac

Another lipoma arborescens?

#likebuses Image
Treating this as typical RCRP / subacromial pain would be fruitless - the pathology causing space occupying effect and if anything loading would perpetuate the cycle by provoking further bursal inflam fluid. POCUS can and does define treatment strategy & prognosis
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