I think that the Coracoacromial Ligament- (CAL) should and must be part of The routine shoulder ultrasound . It will take one minute to scan it from insertion to insertion ,and most of the time you can scan all the ligament in one image.
Other wise for big shoulder you can split screen and scan the ligament , measure its thickness and make sure it is not rupture ,or thick, no fluid around it and no hypermia.
Coracoacromial Ligament is a strong triangular band, extending between the coracoid process and the acromion. It is very easy to scan .Using the sagital scan of your linear transducer one edge of the transducer on the corocoid process and the other end of the transducer toward the Acromion.
Try to angle the transducer slightly anterior to posterior .
It is attached, by its apex, to the summit of the acromion just in front of the articular surface for the clavicle; and by its broad base to the whole length of the lateral border of the coracoid process.
This ligament, together with the coracoid process and the acromion, forms a vault for the protection of the head of the humerus.
Thats why for any shoulder and humerus head trauma we must image this ligament .
It is in relation, above, with the clavicle and under surface of the Deltoideus; below, with the tendon of the Supraspinatus, a bursa being interposed.
Its lateral border is continuous with a dense lamina that passes beneath the Deltoideus upon the tendons of the Supraspinatus and Infraspinatus.
The ligament is sometimes described as consisting of two marginal bands and a thinner intervening portion, the two bands being attached respectively to the apex and the base of the coracoid process, and joining together at the acromion.
When the Pectoralis minor is inserted, as occasionally is the case, into the capsule of the shoulder-joint instead of into the coracoid process, it passes between these two bands, and the intervening portion of the ligament is then deficient.
Thank you for reading.
Steve Ramsey, PhD.
Calgary, Alberta- Canada.