Coracoid Impingement

Subacromial impingement syndrome, or rotator cuff disease, is a common cause of shoulder pain. A less frequently recognized cause is coracoid or subcoracoid impingement. There have been only a few reports of this condition in the literature, and although there are definitely cases that go unrecognized, coracoid impingement is probably a relatively uncommon cause of shoulder pain. Patients with this disorder usually have localized pain anteriorly, especially with forward elevation, internal rotation, and cross arm adduction. Symptoms are presumed to be the result of impingement of the subscapularis tendon between the coracoid process and the lesser tuberosity. Initial treatment is nonoperative and based on activity modification and physical therapy, but operative decompression may be required if conservative measures fail. The following is a case report of coracoid impingement treated by operative decompression.