Subacromial impingement Flashcards
What is subacromial impingement syndrome?
inflammation and irritation of the rotator cuff tendons as they pass though the subacromial space, resulting in pain, weakness and reduced range of motion within the shoulder
What can cause subacromial impingement syndrome?
Rotator cuff tendnosis, subacromial bursitis, calcific tendinitis as they all cause attrition between the coracoacromial arch and the supraspinatus tension or subacromial bursa
Where is the subacromial space?
below the coracoacromial arch and above the humeral head and greater tuberosity of the humerus, the arch consist of the acromion, the coaracoacromial ligament and the coracoid process
What runs in the subacromal space?
rotator cuff tensions, the long head of the biceps tension, the coaracoacromial ligament all surrounded by the subacroial bursa which helps t reduce friction between these structures
What are the intrinsic mechanisms of subacromial impingement syndrome?
pathologies of the rotator cuff tendons due to tension, such as muscular weakness, overuse of the shoulder, degenerative tendiopathy
What are the extrinsic mechanisms of subacromial impingement syndrome?
anatomical factors, scapular musculature, glenohumeral instability
What are the clinical features of subacromial impingement syndrome?
Progressive pain in the anterior superior shoulder, exacerbated by abduction in the affected shoulder and relieved by rest, weakness and stiffness secondary to pain,
What examination signs can be elicited in causes of subacromial impingement syndrome?
Neers impingement test, Hawkins test
What are the differential diagnosis of subacromial impingement syndrome?
Muscular tear, neurological pain, frozen shoulder syndrome, acromioclavicular pathology
What are the investigations for subacromial impingement syndrome?
clinical, then confirmed by imaging, MRI will show subacromial osteophytes, sclerosis, subacromial bursitis, humeral cystic changes and narrowing of the subacromial space
What is the conservative management of subacromial impingement syndrome?
analgesia, NSAIDs, physiotherapy, postural stability, mobility, stretching and strength, corticosteroid injections, warm up techniques and monitoring
What is the surgical intervention fro subacromial impingement?
beyond 6 months without a response to conservative management will do a surgery to repair muscle tears, remove the subacromial bursa or remove some of the acromion
What are the complications fo subacromial impingement?
rotator cuff degeneration and tear, adhesive capsulitis, cuff tear arthroplasty and complex regional pain syndrome
