Subacromial Impingement Syndrome Flashcards
What is SAIS
Inflammation and irritation of the rotator cuff tendons as they pass through the subacromial space
What is the epidemiology of SAIS
Under 25 years old pts
Typically occur in active individuals
Most common shoulder pain complaint
what does the coracoacromial arch consist of
the acromion, the coracoacromial ligament (anterior to the acromioclavicular joint), and coracoid process.
What runs in the subacromial space
rotator cuff tendons, the long head of biceps tendon, and the coraco-acromial ligament
What can the underlying causes of SAIS be categorised into
Intrinsic and extrinsic
What do intrinsic mechanisms involve
pathologies of the rotator cuff tendons due to tension such as:
- muscular weakness
- overuse of shoulder
- degenerative tendinopathy
What do extrinsic mechanisms include
pathologies of the rotator cuff tendons due to external compression such as:
- anatomical factors
- scapular musculature
- glenohumeral instability
What are the clinical features of SAIS
Progressive pain
Exacerbated by abduction
Weakness and stiffness in affected shoulder
what are two examination signs that can be ilicited
Neers impingement test - arm by pts side and internally rotated. Then passively flexed - +ve if pain in anterolateral part of shoulder
Hawkins test - shoulder and elbow flexed at 90 degrees and examiner presses down on arms
what are the differential diagnoses
Muscular tears
Neurological pain
Frozen shoulder
Acromioclavicular pathology
What are the investigations of SAIS
Diagnoses is clinical
MRI
what is the conservative management of SAIS
Analgesia - NSAIDs
Physiotherapy
Stretching
Corticosteroid injections
When is surgical treatment indicated
6 months without response to conservative management
What are the surgical techniques available
Surgical repair of muscular tears
Surgical removal of the subacromial bursa, a bursectomy
Surgical removal of a section of the acromion, an acriomioplasty,
What are the complications of SAIS
rotator cuff degeneration and tear, adhesive capsulitis, cuff tear arthropathy and complex regional pain syndrome.
