Impingement syndrome

Question 1

MOI for impingement syndrome

Answer 1

Nothing, repetitive stress, type 1-3 acromion

Question 2

3 types of acromions

Answer 2

1-flat
2-curved
3-hooked

Question 3

Which type of acromion leads to rotator cuff tears

Answer 3

Type 3-hooked

Question 4

If a pt. is young, pain for 6 weeks, no trauma, and has pain w/ repetitive motions, what is the tx plan?

Answer 4

First line therapy is rest, NSAIDs, physical therapy

Question 5

What is the difference between Neer’s impingement sign and test

Answer 5

Sign: passively flexing pt’s shoulder»>send to PT
Test: diagnostic and therapeutic: inject anesthetic into subacromial space and if pain goes away then it confirms impingement

Question 6

What are exacerbating movements for imingement syndrome

Answer 6

anything above the shoulder level

“back seat sign” internal rotation

Question 7

What is the tx algorithm for impingement syndrome

Answer 7

PT-low weight, high reps
NSAIDs, stretching, avoid resistance training until pain improves
inject at 6 or 12 weeks
MRI or US 3-4 months later if no improvement