Diagnosing subcoracoidal impingement with dynamic ultrasound

The subcoracoid bursa is located between the coracoid process, the conjoint tendon (of the biceps short head and coracobrachialis) and the subscapularis, and minimizes the friction between the coracoid and the subscapularis. The subcoracoid bursa occasionally communicates with the subacromial bursa and merges with the superior subscapularis recess known as subscapularis bursa (under the subscapularis). Subcoracoid impingement syndrome is usually diagnosed clinically with anterior shoulder pain with positive provocative tests and possibly in some professions with a diagnostic injection. 

Ultrasound (US) is helpful in evaluating the anatomical structures located in the anterior shoulder region, including the subscapularis muscle/tendon, coracoid process and subcoracoid bursa. Ultrasound (US) is an effective modality to evaluate these anatomic structures, and the ability to perform a dynamic evaluation can be useful to assess snapping or impingement and to aid in narrowing the differential diagnosis of anterior shoulder pain.