Subcoracoid impingement study was inconclusive in five patients, impingement was present in four patients and absent in 26 patients.
In our study sensitivity, specificity and accuracy for diagnosis of subacromial subdeltoid bursa, subcoracoid bursa and bicepital groove effusions were all above 90%, whereas sensitivity, specificity and accuracy of detecting glenohumeral joint effusion were 50%, 86% and 82% respectively with no significant p value difference.
Diagnostic accuracy of dynamic evaluation using ultrasound in our patient for subcoracoid impingement is significantly high when compared to MRI with p value difference of 0.
Of 32 cases of chronic shoulder dislocation3 all were unilateral (31 anterior subcoracoid
and 1 posterior) dislocations.
A thickened CHL and joint capsule, decreased axillary recess volume and obliteration of the subcoracoid
fat triangle was used for presumptive MR arthrographic diagnosis of adhesive capsulitis (3,8).
Similar differential testing is possible for pain on resisted medial rotation, to determine whether the tendons of subscapularis and long head of biceps (LHB) or other adjacent structures are impinged within the subcoracoid space.
Assessment of other muscles in the shoulder complex as sources of pain does not create the same difficulties as the rotator cuff and biceps, as they are not influenced by anatomical positions within confined areas such as the subcoracoid or subacromial spaces, nor is there such intimate interdigitation of their fibres.
Table 1 Acromioclavicular Injury Classification Type AC Ligament CC Ligament Deltotrapezial Fascia 1 Sprained Intact Intact 2 Disrupted Sprained Intact 3 Disrupted Disrupted Insertion intact 4 Disrupted Disrupted Disrupted 5 Disrupted Disrupted Disrupted 6 Disrupted Disrupted Disrupted Type Radiographic Findings 1 Normal 2 AC joint widening, slight elevation of distal clavicle 3 CC distance 25% to 100% compared to contralateral 4 CC distance 25% to 100% and posterior displacement of clavicle 5 CC distance 100% to 300% 6 Subacromial or subcoracoid
Type VI: This rare injury involves inferior displacement of the clavicle either subacromial or subcoracoid behind the conjoined tendon.
Wolf and Pennington originally described an arthroscopic technique that involves passing sutures through tunnels created through the distal clavicle and coracoid with an arthroscopic subcoracoid drill guide.
Consequently, subcoracoid (under the conjoint tendon) transfers of the pectoralis major have been recommended to change its line of action and better mimic the subscapularis (Fig.
Techniques transferring the sternal head in a subcoracoid fashion may improve results by closer mimicking the biomechanics of the subscapularis, reducing the bulk of the transfer and improving cosmesis.