Coracoid Impingement Syndrome Research Articles

Dual osteochondromas arising from the coracoid process and the glenoid of scapula

Abstract Introduction: Scapular osteochondromas represent 3% to 4% of all osteochondromas. Although many cases of osteochondromas affecting the body of the scapula have been reported in the first three decades of life, case reports of osteochondroma affecting the coracoid process or the glenoid of the scapula are limited. Patient concerns: We report a case of a 56-year-old male with progressive pain and swelling of the left shoulder for six months. Diagnoses: The diagnosis was dual osteochondromas arising from the coracoid process and the glenoid of the left scapula. Interventions: Complete excision was performed. Outcomes: The patient was discharged without any complications after 10 days of postoperative wound care. His symptoms relieved at three months after surgery. At the last follow-up (two years postoperatively), the patient remained in good condition. He had full range of motion of the shoulder without any signs of recurrence. Conclusion: Dual osteochondromas arising from the glenoid and the coracoid process can cause severe dysfunction with coracoid impingement syndrome of the ipsilateral shoulder. In older individuals, it is necessary to differentiate osteochondroma from a malignant tumor.

Measurement of the coracohumeral distance on magnetic resonance imaging in a large patient cohort

Coracoid impingement syndrome is an increasingly recognized etiology of anterior shoulder pain. Numerus studies have documented the coracohumeral distance (CHD) as a primary or secondary measurement in symptomatic individuals, but there lacks an evaluation of CHD in a large cohort of asymptomatic individuals. The purpose of this study was to quantify a normative distribution of the CHD in a large cohort of healthy, asymptomatic subjects with no history of impingement or shoulder instability. Incoming first-year students in the United States Military Academy were offered enrollment in this study as part of a prospective cohort to assess the normal anatomic relationships of the shoulder girdle. Magnetic resonance images were obtained, and a board-certified, fellowship-trained musculoskeletal radiologist performed measurements of the smallest distance from the coracoid to the humeral head on axial images. Magnetic resonance images of 714 subjects were available for analysis, including 630 males and 84 females, with a total of 1120 individual shoulders with images of adequate quality. The mean CHD for all shoulders imaged was 13.7 mm. The mean CHD in male shoulders was 13.8 mm, and in female subjects the average was 12.4 mm. This study is the largest of its kind to evaluate the CHD in asymptomatic, healthy shoulders to dateand demonstrates a mean CHD of 13.7 mm for all subjects. This information can help to standardize "normal" ranges and act as a comparison for future work, when taken in the context of age and imaging in neutral rotation.

Subcoracoid Impingement – A Global View

Abstract Modifications in joint anatomy on both soft and bony tissue level play a key role in subcoracoid impingement syndrome. The diagnostic is primarily clinical and is based on patient history and functional tests. Imaging tests support, but do not establish the diagnostic. Approach can take the form of targeted exercises with progressive load, or that of invasive surgery. Shoulder pain has a diverse etiology which derives from the complex local anatomy which includes the clavicle, acromion, coracoid process and humeral head, the soft tissues surrounding this area, in particular the rotator cuff, but can also be unrelated to all of the above and be a reflection of a pathology located in the neck, arm or trunk, or adjacent visceral organs. More often, it is the manifestation of a traumatic episode or an anatomical anomaly, or it can be secondary to inflammation, tumors, or surgery. It is the third most common musculoskeletal complaint presenting to physiotherapy, and largely impacts both an individual’s quality of life and the public health system. Coracoid impingement syndrome can present itself as a cause of rotator cuff disease, but its role is not fully established yet. It is less prevalent than subacromial impingement, can coexist with it, and therefore should be considered into the differential diagnosis of anterior shoulder pain when a patient presents themselves with activity related anterior shoulder pain.

양궁 선수의 오구 충돌 증후군의 치료 후 발생한 회전근 간격의 손상에 대한 치료 - 증례 보고 -

Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.

Coracoid Impingement Syndrome Due to Intensive Rock Climbing Training

Overuse and acute injuries to the upper body are common in rock climbing. Such injuries primarily affect the fingers; but shoulder problems are increasingly common, especially among more experienced and older climbers who climb at a high ability level. Such shoulder problems are often due to subacromial impingement, shoulder dislocations with bankart lesions, hyperlaxity, SLAP lesions or irritations of the long biceps tendon. In contrast to these known conditions, we describe a case of an ambitious female rock climber who trained intensively and developed a coracoid impingement caused by hypertrophied subscapularis tendon and muscle following sport-specific training. Diagnosis was made through clinical evaluation and confirmed by magnetic resonance tomography. Coracoid impingement syndrome is a less common cause of shoulder pain and occurs when the subscapularis tendon impinges between the coracoid and the lesser tuberosity of the humerus. The patient was treated successfully with a conservative therapy and returned to full activity within 6 weeks.

Coracoid Impingement Treated with Corrective Osteotomy. A Case Report

Coracoid impingement syndrome is a rare cause of anterior shoulder pain. It is mainly a diagnosis of exclusion after considering the more common subacromial impingement. We describe a case of coracoid impingement and a novel approach to its management: coracoid osteotomy as opposed to the more commonly used technique of coracoplasty. A review of the literature is also presented in relation to this condition. Coracoid osteotomy with internal fixation allows good stability with reliable direct bone-to-bone healing. Coracoid osteotomy is a reliable and a satisfactory alternative to the more commonly-used technique of coracoplasty for the treatment of idiopathic coracoid impingement syndrome.

Coracoid impingement syndrome: a literature review

Coracoid impingement syndrome is a less common cause of shoulder pain. Symptoms are presumed to occur when the subscapularis tendon impinges between the coracoid and lesser tuberosity of the humerus. Coracoid impingement should be included in the differential diagnosis when evaluating a patient with activity-related anterior shoulder pain. It is not thought to be as common as subacromial impingement, and the possibility of the coexistence of the two conditions must be taken into consideration before treatment of either as an isolated process. If nonoperative treatment fails to relieve symptoms, surgical decompression can be offered as an option.

Coracoid process anatomy: Implications in radiographic imaging and surgery

The coracoid process forms an important part of scapular-glenoid construct and is involved in many surgical procedures on the glenohumeral joint. The unique three-dimensional orientation of each coracoid pillar makes radiographic imaging difficult. Congenital variations and minimal traumatic/iatrogenic changes in this orientation can predispose to subcoracoid impingement. We performed a quantitative and statistical analysis of the osseous anatomy of the coracoid process in 101 scapulae; the purpose was to determine the anatomical variations and gender-specific differences in the length, breadth, thickness, vertical and horizontal projections, and triplane angulations of each individual coracoid pillar. All parameters were measured in reference to the glenoid plane to ensure surgical and radiological applicability. The mean dimensions of the inferior coracoid pillar were 31.1 x 16.6 x 9.9 mm and that of the superior coracoid pillar were 41.7 x 14.2 x 8.4 mm (medial)/6.6 mm (lateral). The mean maximal harvestable coracoid length measured 19.0 mm. The mean angular orientation of the inferior coracoid pillar, with reference to the glenoid, measured 51.2 degrees (axial), 126.1 degrees (sagittal), and 134.6 degrees (coronal), and that of the superior coracoid pillar measured 146.1 degrees (axial) with an interpillar angulation of 84.9 degrees (axial). A statistically significant gender difference (P < 0.05) was found in the lengths, breadths, and projections of each coracoid pillar. We used data from this study to devise two new radiographic views (for imaging individual coracoid pillars), to calculate dimensions and orientation of internal fixation/prosthetic hardware during surgery, and conceptualize a geometric model to explain the role of measured parameters in coracoid impingement syndrome.

Coracoid Impingement Syndrome: A treatable cause of anterior shoulder pain

Coracoid Impingement Syndrome is a relatively uncommon but generally treatable cause of anterior shoulder pain that can be easily overlooked. It typically presents with anterior shoulder joint pain in activities involving forward flexion, adduction and internal rotation. To assess the outcome of a cohort of patients diagnosed with Coracoid Impingement Syndrome. Patients were investigated clinically and radiologically. They received appropriate therapeutic measures and were followed-up in an orthopaedic outpatient setting. Twelve patients were identified over a four-year period. All patients have made good progress. Thus far, none have needed operative intervention for symptom relief. Coracoid impingement syndrome is an uncommon cause of anterior shoulder pain but diagnosed patients can expect good symptomatic relief following referral to a dedicated shoulder unit. An increase in clinical awareness of the condition may prevent undue diagnostic delay in such cases.

Arthroscopic treatment of coracoid impingement

A review of the literature reveals that surgical treatment of coracoid impingement has heretofore involved open surgical decompression in all cases. Previously unreported, the authors describe an arthroscopic technique to treat coracoid impingement syndrome, demonstrate its feasibility, and cover the specific technical points that facilitate this procedure.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 7 (September), 2001: pp 784–787

Old Unreduced Posterior Sternoclavicular Dislocation and Coracoid Impingement

Old Unreduced Posterior Sternoclavicular Dislocation and Coracoid Impingement

CORACOID IMPINGEMENT SYNDROME, ROTATOR INTERVAL RECONSTRUCTION, AND BICEPS TENODESIS IN THE OVERHEAD ATHLETE

Anterior shoulder problems are extremely common in throwing athletes. Coracoid impingement syndrome, lesions of the long head of the biceps tendon, and rotator interval lesions are included in the extensive differential diagnosis which exists for anterior shoulder pain. In this article, we focus on the anatomy, pathophysiology, clinical presentation, diagnosis, and surgical treatment of these conditions.

Coracoid impingement syndrome, rotator interval reconstruction, and biceps tenodesis in the overhead athlete

Anterior shoulder problems are extremely common in throwing athletes. Coracoid impingement syndrome, lesions of the long head of the biceps tendon, and rotator interval lesions are included in the extensive differential diagnosis which exists for anterior shoulder pain. In this chapter, we focus on the anatomy, pathophysiology, clinical presentation, diagnosis, and surgical treatment of these conditions.

Rotator interval lesions and their relation to coracoid impingement syndrome

In the last 10 years we have found impingement of the coracoid process on the rotator interval in 12 patients (14 shoulders). Seven of these patients were women and 5 were men; the average patient age was 48.5 years. One patient had a calcified coracohumeral ligament, another patient had an anterior tear of a repaired deltoid flap, and a third had an aberrant pectoralis minor tendon inserted into the rotator interval. Eleven patients had a weak rotator interval, and in 4 cases the rotator interval had a small tear. We closed the rotator interval in all 12 patients. We also performed a coracoidoplasty in 5 of the patients. The condition of all shoulders improved clinically after operation; the average follow-up was 4.2 years. Three patients (4 shoulders) still had moderate pain, and 7 patients (9 shoulders) lacked strength. Internal rotation was the only shoulder movement that remained limited. Although impingement seemed obvious during surgery, experimental studies have reported contradictory findings.