Subcoracoid

Subcoracoid refers to a location beneath the coracoid process of the scapula, on the anterior aspect of the shoulder girdle. The coracoid process is a hook-like projection that serves as an attachment for several muscles and ligaments, and the term subcoracoid is used to describe structures, spaces, or pathologies in this region.

Anatomy and relationships: The subcoracoid space lies immediately inferior to the coracoid process. Muscular attachments to the coracoid include the short head of the biceps brachii, coracobrachialis, and pectoralis minor; the coracohumeral ligament also extends from the coracoid to the humerus, contributing to the boundaries of this region. The subcoracoid space may contain the subcoracoid bursa, and this area can be involved in impingement phenomena with the subscapularis tendon and the biceps tendon during shoulder movement.

Clinical significance: Subcoracoid impingement is a condition characterized by abnormal contact between the coracoid process or its soft tissue attachments and the rotator cuff tendons or the biceps tendon during arm elevation, causing anterior shoulder pain. It is considered a variant of shoulder impingement and may be associated with a prominent coracoid, scapular dyskinesis, or hypertrophy of overlying soft tissues. Management may include physical therapy and, in some cases, surgical decompression to widen the subcoracoid space.

Imaging and diagnosis: Radiographs can assess the coracoid process and subcoracoid space, while MRI or CT provides detailed evaluation of soft tissue structures, the subcoracoid bursa, and any impinging lesions.