Shoulder Impingement syndrome

Question 1

what is impingement syndrome in the shoulder also called

Answer 1

painful arc

Question 2

describe what impingement syndrome in the shoulder is

Answer 2

when the tendons of the rotator cuff are compressed in the tight subacromial space during movement, producing pain

Question 3

what rotator cuff tendon is predominantly involved in shoulder impingement syndrome

Answer 3

supraspinatus

Question 4

describe the “painful arc” seen in shoulder impingement syndrome

Answer 4

when patient has pain between around 60 to 120 degrees of abduction of upper limb, as they ‘arc’ their arm

Question 5

what are some causes of shoulder impingement syndrome

Answer 5

tendonitis, subacromial bursitis, acromioclavicular OA, a hooked acromion rotator cuff tear

Question 6

what clinical features are seen in shoulder impingement syndrome

Answer 6

pain that radiates to deltoid and upper arm, may be tenderness at lateral edge of acromion, +ve Hawking-Kennedy test

Question 7

what condition should be excluded in investigation and diagnosis of shoulder impingement syndrome

Answer 7

cervical radiculopathy

Question 8

what treatment is used in the first instance of shoulder impingement syndrome

Answer 8

NSAIDs, analgesics, physio, and subacromial steroid injection

Question 9

up to how many subacromial steroid injections may be needed to treat impingement syndrome

Answer 9

up to 3

Question 10

what treatment may patients benefit from if symptoms do not improve with conservative management

Answer 10

subacromial decompression surgery to create more space for tendon to pass through
(can be open or arthroscopic)