The Acromion’s Role in Impingement

Syndrome

Impingement of the rotator cuff usually involves thickening

of the acromion. The portion that usually is most thickened

or responsible for impingement is the anterior portion,

which often develops an exostosis or large osteophyte.

The Coracoid Process as a Bony Landmark

With the arm by the side, the tip of the coracoid process

is oriented anteriorly. It can be palpated by applying deep

pressure through the anterior portion of the deltoid muscle approximately 2.5 cm below the lateral part of the

clavicle on the lateral side of the infraclavicular fossa.

Because muscles (pectoralis minor, short head biceps,

coracobrachialis) and ligaments (coracoclavicular and

coracoacromial ligaments) attach to the coracoid process,

and because of the close vicinity of the musculocutaneous

1 Skeletal Anatomy 17

nerve, the coracoid is a valuable palpable landmark for orientation in terms of these structures. The coracoid process

also serves as a valuable landmark for operative approaches

to the glenohumeral joint and the brachial plexus. In addition, the base of the coracoid process forms a portion of

the suprascapular notch. It can be a potential aid in the

localization of the suprascapular nerve and suprascapular

notch.