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Fig. 3 —Subjective drawing (not based on cadaveric model) of
subacromial impingement with soft-tissue involvement. Drawing (coronal plane,
cut section) of left shoulder during active elevation of arm halfway between
flexion and abduction with hand in pronation explicitly depicts pooling of
fluid in lateral aspect of subacromial-subdeltoid bursa (arrow) and
alteration of normally convex surface of supraspinatus tendon
(arrowhead) as arm is elevated. Supraspinatus tendon is not always
involved in grade 2 subacromial impingement. There is also evidence of
supraspinatus tendinosis and inflammatory changes in bursa.
