The coracoid impingement of the subscapularis tendon: A cadaver study

Radas, Carsten B.; Pieper, Hans-Gerd

doi:10.1016/j.jse.2003.12.007

Cited by 44 publications

(27 citation statements)

References 5 publications

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“…It seems to appear as a combination of intrinsic factors (for example age, tendon histology and genetics), and extrinsic factors, which are those more closely related to CHD, such as anatomic differences for humerus lesser tuberosity and coracoid process [6, 8]. Also, anteversion, internal humeral rotation [7], and a history of chronic overuse of persisted flexion, adduction and internal rotation shoulder position [9]. The controversy in regard to the exact pathomechanics and biomechanical causes of shoulder pain is reasonable.…”

Section: Discussionmentioning

confidence: 99%

“…Although it can occur alone, it usually presents with anterolateral shoulder pain (labeled as subacromial pain syndrome), sharing similar symptoms [5] and making it difficult to diagnose. The most related cause of anterior shoulder pain is subcoracoid impingement syndrome, defined as the encroachment of the posterolateral coracoid process upon the lesser tuberosity of the humerus [6], causing a compression of soft tissues, such as the subscapularis tendon, glenohumeral joint capsule and subcoracoid bursa, and occasionally the long head of the biceps tendon [7]. Anatomic differences for humerus lesser tuberosity and coracoid process [6, 8], as well as anteversion and internal humeral rotation [7], and a history of chronic overuse of persisted flexion, adduction and internal rotation shoulder positions [9], have also been established as possible causes of anterior shoulder pain.…”

Section: Introductionmentioning

confidence: 99%

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Is coracohumeral distance associated with pain-function, and shoulder range of movement, in chronic anterior shoulder pain?

Navarro-Ledesma

Struyf

Manzanares

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe aim of this study was twofold: (i) to assess the intrarater reliability of coracohumeral distance; (ii) to investigate the level of association between coracohumeral distance measured by ultrasonography, and pain-disability and shoulder range of movement, in patients suffering from chronic anterior shoulder pain.MethodsAn observational, cross sectional study was carried out. A convenience sample comprised of 87 patients with chronic anterior shoulder pain was assessed from 3 primary care centres. Main outcomes as pain and function were measured through the shoulder pain and disability index. Furthermore, shoulder range of movement-free of pain in shoulder elevation, as well as coracohumeral distance at both 0 and 60 degrees, were collected.ResultsAbsence of any correlation was found between coracohumeral distance and shoulder pain and disability index at both 0 and 60 degrees of shoulder elevation. Furthermore, absence of any correlation was found between coracohumeral distance measurements and active shoulder range of movement -free of pain.ConclusionsThere was poor association between coracohumeral distance and shoulder pain and function, as well as with shoulder range of movement, in patients with chronic anterior shoulder pain. Hence, clinicians should consider, not only increasing this space, but also other possibilities in their therapies, when patients with anterior shoulder pain are treated.Trial registration ACTRN12614000144617. Registered: 1st March 2014.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is coracohumeral distance associated with pain-function, and shoulder range of movement, in chronic anterior shoulder pain?

Navarro-Ledesma

Struyf

Manzanares

et al. 2017

BMC Musculoskelet Disord

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“…This apparent disagreement has led us to believe that a larger number of properly studied CIS cases are required to prove the diagnostic value of that parameter. 17 In spite of the complex anatomy of the subcoracoid space, we believe that a safe surgical approach of the CP is possible, provided that disinsertion of the joint tendon is avoided-a recommendation that we make-to prevent the risk of damaging the important neurovascular structures described above.…”

Section: Discussionmentioning

confidence: 97%

An Anatomical Study of the Subcoracoid Space

Neto¹,

Almeida²,

Maiorino³

et al. 2006

Clinics

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PURPOSE:To evaluate the amplitude of the subcoracoid space under maximum internal and external rotations of the humeral head and measure the distance between the apex of the coracoid process and the following anatomical structures: (a) point of entry of the musculocutaneous nerve and its branches into the coracobrachial muscles and into the short head of the biceps brachii muscle; (b) acromial artery; (c) lesser tubercle of the humerus. METHOD: Thirty shoulders of fresh cadavers, without any kind of shoulder pathology, (9 males and 6 females) were dissected, and the distances (in mm) were measured between the anatomical structures defined above and the apex of the coracoid process. RESULTS:The mean distance between the apex of the coracoid process and the musculocutaneous nerve was 49.2 mm (in all specimens a proximal branch of the nerve was identified 34.2 mm away from the apex of the coracoid process), which was not significantly different between the sexes or body sides; the mean distance between the apex of the coracoid process and the acromial artery was 12.4 mm, which was not significantly different between the sexes or body sides; the mean distance between the apex of the coracoid process and the lesser tubercle of the humerus, with the humeral head under internal rotation, was 10.6 mm in men and 8.6 mm in women, values that were significantly different between the sexes. DISCUSSION: In women, the smaller distance between the apex of the coracoid process and the lesser tubercle of the humerus in the arm internal rotation suggests a higher chance of impingement between those bone structures among the female sex.

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“…Anterosuperior internal impingement has been associated with these biceps pulley lesions, as well as anterior articular-sided partial-thickness rotator cuff tears and anterosuperior labral lesions. 19,29,31,41,42,44,76,85 Posterosuperior internal impingement has been associated with posterior articular-sided partial-thickness rotator cuff tears and posterosuperior labral lesions. 14,[40][41][42]54,56,81,90 We believe that truly superficial articular-sided rotator cuff tears actually represent damage to the superior complex rather than to the rotator cuff tendons themselves.…”

Section: Discussionmentioning

confidence: 99%