Impingement Syndrome

Question 1

What is impingement syndrome?

Answer 1

Rotator cuff tendons (mainly supraspinatus) are compressed in the subacromial space during movement

Question 2

Signs & symptoms of impingement syndrome?

Answer 2

• Painful arc between 60-120 degrees of abduction
• Pain radiates to deltoid & upper arm
• Tenderness below the lateral edge of acromion
• Hawkins-Kennedy test (internally rotating flexed shoulder): recreates pain
• Cervical radiculopathy should be excluded form history and examination

Question 3

Causes of impingement syndrome?

Answer 3

• Tendonitis
• Subacromial Bursitis
• Acromioclavicular OA with inferior osteophyte
• Hooked acromion
• Rotator cuff tear

Question 4

Treatment for impingement syndrome?

Answer 4

Conservative:

• NSAIDs
• Analgesics
• Physiotherapy
• Subacromial injection of steroid (up to 3)

If no improvement:
-Subacromial depression surgery

Question 5

What does subacromial depression surgery do to help with impingement syndrome?

Answer 5

Create more space for tendon to pass through