This composite educational graphic focuses on shoulder anatomy and surface landmark localization for clinical procedures. Figure (a) is an anatomical diagram of the right shoulder joint depicting the scapula, clavicle, and proximal humerus. It highlights the coracoclavicular and acromioclavicular ligaments, as well as the glenohumeral capsule. A horizontal black line illustrates the measurement distance between the coracoid process and the intertubercular (bicipital) groove. Figure (b) is a clinical photograph showing the anterior aspect of a human male's left shoulder with surface markings. Vertical skin markings labeled A, B, and C correspond to the underlying anatomy: (A) represents the coracoid process, (B) marks the intertubercular groove at 0° of external rotation, and (C) marks the same groove at 45° of external rotation. Visible ultrasound gel near markings B and C suggests that these points were localized using musculoskeletal ultrasound. This material is designed to teach clinical localization of the long head of the biceps tendon relative to fixed bony landmarks for diagnostic or therapeutic injections.

Anatomical Diagram and Clinical Overlay: This image depicts a surgical planning or post-operative schematic for a nerve transfer procedure on the right shoulder of a male patient. The visual combines a clinical photograph with color-coded overlays to illustrate the thoracodorsal nerve (TDN) to suprascapular nerve (SSN) transfer. Key anatomical landmarks are identified, including the cervical roots (C5 and C6) in the neck region and the suprascapular notch near the superior border of the scapula. A green line traces the distal path of the TDN terminal branches as they are mobilized superiorly from the axillary/lateral thoracic region toward the shoulder. A blue line represents the SSN, originating from the brachial plexus and traveling under the clavicle. The point of neurorrhaphy (nerve repair) is indicated where the green and blue lines meet within the deltopectoral groove, just inferior to the suprascapular notch. This diagram demonstrates the surgical management of an upper brachial plexus injury by utilizing a functional motor nerve donor (TDN) to reinnervate the target muscles of the suprascapular nerve.

This clinical photograph shows a posterior view of a patient's upper back and shoulders during a wall-push physical examination maneuver. The image demonstrates a clear case of right-sided scapular winging. Specifically, the right scapula is displaced laterally and posteriorly, with its medial border and inferior angle protruding prominently from the thoracic cage. This creates a visible asymmetric contour when compared to the neutral, stabilized left scapula. The right shoulder also appears slightly depressed. This clinical finding is often associated with neurological or muscular dysfunction, such as long thoracic nerve palsy affecting the serratus anterior muscle or injury to the spinal accessory nerve affecting the trapezius. The visual evidence of winging during forward flexion or a wall-push highlights the instability of the scapulothoracic joint, which is a key diagnostic sign in patients presenting with shoulder pain, weakness, or limited range of motion related to brachial neuritis or other neuromuscular conditions.

This anteroposterior (AP) X-ray of the right shoulder demonstrates an insufficiency fracture of the scapular spine, indicated by a white arrow. There is visible disruption of the cortical continuity of the scapula with associated periosteal reaction and hazy callus formation around the fracture site, though a clear fracture line remains, signifying a lack of complete bony consolidation. The image reveals generalized osteopenia with thinning of the cortical bone and decreased trabecular density, consistent with the patient's history of osteoporosis and chronic corticosteroid use. Additionally, there is superior migration of the humeral head relative to the glenoid, suggesting a chronic rotator cuff deficiency. The glenohumeral and acromioclavicular joints appear relatively preserved in terms of joint space. This imaging is clinically significant for evaluating non-traumatic or insufficiency fractures in elderly patients presenting with progressive shoulder pain and functional impairment.