subacromialen

Subacromialen, commonly referred to as the subacromial space, is an anatomic region of the shoulder located beneath the acromion and coracoacromial arch. It is bounded superiorly by the acromion and arch and inferiorly by the head of the humerus. The space contains the subacromial-subdeltoid bursa, the tendon of the supraspinatus, and often the long head of the biceps tendon. It provides a lubricated corridor for the rotator cuff tendons to glide beneath the acromion during arm elevation.

Pathology in this region can lead to impingement and pain. Subacromial impingement syndrome occurs when the space narrows or becomes inflamed, compressing the rotator cuff tendons and bursa. Contributing factors include rotator cuff tendinopathy or tears (especially of the supraspinatus), subacromial bursitis, and calcific tendinopathy. Abnormal acromial morphology, such as hooked or curved shapes, or adjacent joint pathology can reduce clearance during overhead activities.

Diagnosis relies on a combination of history, physical examination, and imaging. Patients typically report lateral shoulder pain with overhead movements and may experience a painful arc during arm elevation, commonly around 60 to 120 degrees. Exam findings may include positive impingement signs. Imaging studies such as ultrasound or MRI help assess rotator cuff integrity, bursal inflammation, and other contributing lesions.

Treatment is usually conservative at first. Management includes activity modification, targeted physical therapy (focusing on scapular stabilization and rotator cuff strengthening), nonsteroidal anti-inflammatory drugs, and corticosteroid injections when appropriate. If nonoperative measures fail or significant rotator cuff tearing is present, surgical options such as subacromial decompression or acromioplasty may be considered, with rotator cuff repair as needed for tears.