The cuneiform sa sign is a less common-use sign of the Epic of Gilgamesh, the 1350 BC Amarna letters, and other cuneiform texts. It also has a sumerogrammic usage for SA in the Epic of Gilgamesh. The structure of the cuneiform sign is similar to, Ir (cuneiform), 
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The "sa" sign has the syllabic usage for sa, and a Sumerogram usage for SA.
SA in the Epic of Gilgamesh is a logogram for Akkadian "Šer'ānu", translated as: "muscle, sinew".
Epic of Gilgamesh usage
The sa sign usage in the Epic of Gilgamesh is as follows: sa-(89 times); and SA-(2).
References
- Parpola, 1971. The Standard Babylonian Epic of Gilgamesh, Glossary, pp. 119-145, Šer'ānu, p. 142.
- Parpola, 1971. The Standard Babylonian Epic of Gilgamesh, Sign List, pp. 155-165, no. 104, p. 157, "sa".
- Moran, William L. 1987, 1992. The Amarna Letters. Johns Hopkins University Press, 1987, 1992. 393 pages.(softcover, ISBN 0-8018-6715-0)
- Parpola, 1971. The Standard Babylonian Epic of Gilgamesh, Parpola, Simo, Neo-Assyrian Text Corpus Project, c 1997, Tablet I thru Tablet XII, Index of Names, Sign List, and Glossary-(pp. 119–145), 165 pages.