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.
bulging of the acromioclavicular ligament during dynamic scanning in a patient with subacromial impingement