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Coracoacromial ligament – longitudinal

Patient Positioning

Patient seated on a revolving stool, arm in slight external or internal rotation. Elbow flexed (90°), palm up.

Probe Positioning

Find the coracoid process and shift the lateral aspect of the probe in direction of the acromion (upwards and laterally). The coracoacromial ligament can be visualized between the coracoid process and the acromion. External and internal rotation may show anteromedial impingement (bulging of the ligament along with pain, distance between lesser tuberosity and coracoid process in internal rotation). Look for effusion in the subscapularis recess and the subcoracoid bursa.

Shoulder anterior view
Sonogram: Shoulder anterior subscapularis transverse ligamentum coracoacromiale
Sonogram: Shoulder anterior subscapularis transverse ligamentum coracoacromiale

Note: A patient with frozen shoulder may show thickening of the coracoacromial ligament. Use dynamic scanning (internal and external rotation) to check for effusion or impingement.