Coracoid Process: The Lighthouse of the Shoulder

Abstract

The coracoid process is a hook-shaped bone structure projecting anterolaterally from the superior aspect of the scapular neck. Surgeons often refer to the coracoid process as the "lighthouse of the shoulder" given its proximity to major neurovascular structures such as the brachial plexus and the axillary artery and vein, its role in guiding surgical approaches, and its utility as a landmark for other important structures in the shoulder. The coracoid also serves as a critical anchor for many tendinous and ligamentous attachments. These include the tendons of the pectoralis minor, coracobrachialis, and short head of the biceps brachii muscles, and the coracoclavicular, coracohumeral, coracoacromial, and transverse scapular ligaments. Consequently, the coracoid and its associated structures are linked to numerous shoulder pathologic conditions. This article will detail the anatomy of the coracoid and its associated structures and review the clinical and radiologic findings of corresponding pathologic conditions in this region with original illustrations and multimodality imaging examples. Highlighted in this article are the coracoclavicular joint, the classification and management of coracoid fractures, subcoracoid impingement, the coracoacromial arch and subacromial impingement, the coracohumeral ligament and the biceps pulley, the coracoclavicular ligament and its surgical reconstruction, adhesive capsulitis, the suprascapular notch and suprascapular notch impingement, subcoracoid bursitis, coracoid transfer procedures, and coracoid tumors. A brief summary of the pathophysiology, potential causes, and management options for each of the pathologic entities will also be discussed.RSNA, 2016.

An anthropometric evaluation of the scapula, with emphasis on the coracoid process and glenoid fossa in a South African population

“…The coracoid process is a hook-shaped bone structure projecting antero-laterally from the superior aspect of the scapular neck (Mohammed et al, 2016). The coracoid process, aptly defined by Matsen et al (1990) as the "lighthouse of the shoulder", is a reference landmark in arthroscopy for access into the shoulder (Mercer et al, 2011).…”

“…The coracoid process, aptly defined by Matsen et al (1990) as the "lighthouse of the shoulder", is a reference landmark in arthroscopy for access into the shoulder (Mercer et al, 2011). The coracoid process serves as an important anchor for several tendinous and ligamentous structures including the pectoralis minor tendon, coracobrachialis, short head of the biceps brachii muscle, the coracohumeral, coracoacromial, coracoclavicular and suprascapular ligaments (Mohammed et al, 2016).…”

Shoulder Anatomy and Normal Variants

“…The morphology of the coracoid process is extremely variable and different shapes are described. The coracoid overlap and retroversion angle may have a clinical impact on the subcoracoid space and lead to subcoracoid impingement of the subscapularis tendon between the lesser tuberosity and the coracoid process [34611]. …”

“…The anterolateral trapezoid and posteromedial conoid ligaments are identified on coronal oblique and sagittal oblique sections. The main function of these ligaments is to prevent upward dislocation of the clavicle (Figure 2, additional material) [211]. …”

Acromion, coracoid and glenoid processes of scapula: an anatomical study

“…So, the coracoid process is often referred to as the 'lighthouse of shoulder' in orthopedic literature. 2 The anatomy of the coracoid process is thus highly relevant in surgical procedures involving the shoulder joint. Detail knowledge about the dimensions of the coracoid process is helpful in surgical procedures of the shoulder joint like hardware fixation, drill hole placement and prosthetic positioning.…”