The subcoracoid bursa between the subscapularis tendon and the coracoid process can become inflamed in subcoracoid impingement syndrome — compression of the subscapularis tendon in the coracohumeral space. A coracohumeral distance less than 8 mm on MRI combined with bursal fluid and subscapularis tendon signal change confirms subcoracoid impingement.
Reduces friction between the subscapularis and the coracoid process during shoulder movement
Subcoracoid impingement produces anterior shoulder pain that worsens with forward flexion and internal rotation, reproduced by the coracoid impingement test (pain with passive forward flexion and internal rotation). It must be distinguished from subacromial impingement (lateral pain, painful arc) by clinical examination and confirmed by MRI showing the narrow coracohumeral space and bursal fluid.
Subscapularis-coracoid impingement producing anterior shoulder pain managed with physiotherapy and injection, occasionally requiring coracoplasty.
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