Subacromialdekompression

Subacromialdek is not a recognized medical term in standard literature. This article describes the subacromial region of the shoulder and related conditions that commonly involve the space below the acromion.

Anatomy and boundaries

The subacromial space lies beneath the acromion and coracoacromial arch and above the humeral head. It contains important structures such as the subacromial (subdeltoid) bursa, the supraspinatus tendon of the rotator cuff, and the long head of the biceps tendon. The space can be narrowed by bony morphology, thickened ligaments, inflammation, or tendon degeneration, leading to altered mechanics and pain during shoulder movement.

Common conditions

Impingement syndrome is a frequent problem arising from crowding of the subacromial space during arm elevation, often related to rotator cuff tendinopathy, bursitis, or acromial shape. Rotator cuff tears can involve the supraspinatus tendon and may occur with or without impingement. Subacromial bursitis refers to inflammation of the bursa, contributing to pain and limited motion. Less commonly, calcific tendinopathy and inflammatory or degenerative shoulder diseases may involve the subacromial region.

Diagnosis

Clinical evaluation uses history and physical examination to identify pain with overhead activities and night symptoms. Tests such as Hawkins-Kennedy or Neer’s maneuver assess impingement. Imaging includes X-ray to assess acromial morphology and joint spaces; MRI or ultrasound can evaluate tendons, bursae, and soft tissue integrity.

Treatment and prognosis

Initial management is conservative: activity modification, physical therapy emphasizing scapular stabilization and rotator cuff strengthening, nonsteroidal anti-inflammatory drugs, and sometimes corticosteroid injections. Surgical options, such as arthroscopic subacromial decompression or acromioplasty, may be considered for refractory cases. With appropriate therapy, many patients experience improvement, though outcomes depend on the underlying pathology and chronicity.