Impingement Syndrome of the Shoulder

Garving, Christina; Jakob, Sascha; Bauer, Isabel L.; Nadjar, Rudolph; Brunner, U.

doi:10.3238/arztebl.2017.0765

Cited by 130 publications

(163 citation statements)

References 58 publications

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“…Subacromial impingement syndrome (SAIS) is the syndrome associated with compression and inflammation of supraspinatus tendon as it passes through subacromial space. SAIS is mostly diagnosed in the sixth decade of life [1,3,4]. This syndrome usually causes pain on arm elevation Original Article https://doi.org/10.5115/acb.20.166 pISSN 2093-3665 eISSN 2093-3673 thus limits range of motion of the arm [5,6].…”

Section: Introductionmentioning

confidence: 99%

Acromial morphology and morphometry associated with subacromial impingement syndrome

2020

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Acromion is a major associated structure of subacromial impingement syndrome, one of the most common diagnoses in chronic shoulder pain worldwide. The aims of this study are to study morphometry of acromion and to find risk group using acromial morphometry. Total samples were 392 scapulae. The samples were of both sexes, ranging from the age of 31 to 90. Acromion type and osteophytes were observed. Acromial parameters were measured. The relationships were analyzed among acromion type, acromial osteophyte, acromial parameters, age group, sex and side. Curved acromion had the highest prevalence in all age groups. Hooked acromion had the second highest prevalence since the age of 41. Hooked acromion prevalence was higher in male than in female. The highest prevalence of acromial osteophytes was on anteroinferior surface in all age group. The prevalence of acromial osteophytes on anteroinferior surface and acromial facet increased with age. In addition, acromion type was associated with only osteophytes on anteroinferior surface of acromion. Anterior one-third acromial thickness in the age of 31 to 50 was different from those of 51 to 90. There are differences between all parameters and sexes, but not side. General population with age above 50 and concerned male group with age above 40 who have chronic shoulder pain should be investigated for subacromial impingement syndrome. Surgical treatment is recommended because hooked acromion and osteophytes are mostly the root of problem.

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Section: Introductionmentioning

confidence: 99%

Acromial morphology and morphometry associated with subacromial impingement syndrome

2020

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Section: Methodsmentioning

confidence: 99%

“…Magnetic resonance imaging criteria for SIS included: signal intensity changes in tendons suggestive of tendinosis, acromial spur indentation without microstructural changes of rotator cuff muscles and tendons and disappearance of the subacromial fat in coronal plane T1 weighted images. [ 13 ] Exclusion criteria included (i) a history of inflammatory arthritis; (ii) erythema/swelling of the shoulder joint; (iii) neurological deficit of the upper extremities; (iv) shoulder dislocation; (v) presence of partial/full thickness rotator cuff tear, bursitis, calcific tendinitis, or labral tears on MRI; (vi) significant chronic disease; (vii) a history of or current malignancy; (viii) shoulder trauma occurring within the past three months; (ix) SIS treatment within the past three months; (x) physical therapy of the ipsilateral shoulder within the past six months; (xi) non-consent to subacromial injection; (xii) cases in which surgical intervention was deemed to be the appropriate treatment of choice; (xiii) cervical disc/suspicion of a cervical disc pathology; or (xiv) pregnancy and breastfeeding.…”

Section: Methodsmentioning

confidence: 99%

Ultrasound-guided versus blind subacromial corticosteroid and local anesthetic injection in the treatment of subacromial impingement syndrome: A randomized study of efficacy

et al. 2020

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This study aims to compare the effects of ultrasound (US)-guided and blind subacromial corticosteroid and local anesthetic (LA) injection in the treatment of subacromial impingement syndrome (SIS) on shoulder pain, range of motion (ROM), and functionality. Patients and methods: The prospective study was conducted between 01 February 2017 and 31 May 2017. A total of 29 patients with clinical findings and magnetic resonance imaging (MRI) consistent with SIS were randomized into two groups: 14 patients received US-guided subacromial corticosteroid and LA injection and 15 patients received a blind subacromial corticosteroid and LA injection. Patients were evaluated before and one month after treatment. One patient was lost to follow up. The primary outcome measure was a visual analog scale (VAS) for shoulder pain. Secondary outcomes were active shoulder ROM in flexion and abduction, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the modified Constant-Murley Score (CMS). Results: Twenty eight patients (11 males, 17 females; mean age 39.5 in the US guided group and 42.5 in the blind group; range 20 to 64 years in both groups) completed the study. There was a significant improvement in VAS for shoulder pain, active ROM, DASH questionnaire score and modified CMS in both groups four weeks after treatment (p<0.05). There was no between-group difference in VAS, ROM or DASH questionnaire scores. Following treatment, the modified CMS in the US-guided injection group was higher than in the blind injection group (p=0.02). However, when the mean change in modified CMS in the US-guided injection group was compared to that of the blind injection group, the difference was insignificant (p=0.23). Conclusion: Both US-guided and blind subacromial steroid injection improve shoulder pain, ROM, and functionality in SIS; one treatment option was not found to be superior to the other. Therefore, blind injection can be performed in clinical settings where US is not available. Equally, blind injection can also be performed in patients who have a definite diagnosis of SIS based on clinical and MRI findings.

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“…The most adopted classification of SIS has been based on localizing the soft tissue entrapment [ 23 ]. This classification differentiates internal causes - postero-superior impingement [ 72 ] and antero-superior impingement [ 30 ] -, from those occurring externally - “outlet impingement” [ 54 ]-, such as acromial spurs or uncinated acromion morphology causing extrinsic compression of the subacromial bursae and abrasion of the rotator cuff [ 28 ]. Subsequently, Lewis [ 45 ] has explained SIS as a consequence of an underlying loss of strength of the rotator cuff, which leads to an alteration of the centered position of the humerus onto the glenoid fossa [ 46 ].…”

Section: Introductionmentioning

confidence: 99%

Subacromial impingement syndrome: a survey of Italian physiotherapists and orthopaedics on diagnostic strategies and management modalities

Brindisino

Ristori²,

Lorusso

et al. 2020

Arch Physiother

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Background and aim: The subacromial impingement syndrome (SIS) represents a common cause of disability in approximately 74% of patients with Shoulder Pain (SP). Even if contemporary research suggests that this mechanism is not (always) the dominant driver in SP, SIS is still a source of debate among scholars and clinicians. From a clinical point of view, evidence has suggested that clinicians can use both medical and physiotherapy approaches as effective methods to treat SIS. This survey aims to investigate models of management of patients with SIS in a sample of Italian physiotherapist specialists (Orthopaedic Manipulative Physical Therapists, −OMPTs-) and orthopaedic surgeons. Materials and methods: An online survey with 29-item questionnaire was administered to assess the knowledge of OMPTs and orthopaedic surgeons about: a) strategies of clinical examination; b) the role of imaging in the diagnostic process; c) the physiotherapy management; and d) the pharmacological and surgical management in patients with SIS. Results: Six-hundred and twenty-nine respondents completed the survey (511 OMPTs (79.97%) and 128 orthopaedic surgeons (20.03%)). Ninety-two percent (n = 470) of the OMPTs and 80.5% (n = 103) of orthopaedic surgeons stated that in patients with SIS, a combination of diagnostic tests produced better accuracy (p = < 0.001). Twenty point seven % of OMPTs (n = 106) and 4.7% of orthopaedic surgeon (n = 6) stated that the Lift off was the most specific test (p = < 0.001). Four-hundred-and-twenty-four OMPTs (83%) and 40 orthopaedic surgeons (31.3%) answered that the gold standard for diagnosis of a patient with SIS are history and clinical examination (p < 0.001). Conclusion: OMPTs and orthopaedic surgeons approach patients with SIS differently during both the assessment and the treatment. OMPTs appear to be appropriate in planning and managing clinical examination and therapeutic strategies to use with patients with SIS.

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Impingement Syndrome of the Shoulder

Abstract: Randomized controlled therapeutic trials are needed so that a standardized treatment regimen can be established.

Cited by 130 publications

References 58 publications

Acromial morphology and morphometry associated with subacromial impingement syndrome

Acromial morphology and morphometry associated with subacromial impingement syndrome

Ultrasound-guided versus blind subacromial corticosteroid and local anesthetic injection in the treatment of subacromial impingement syndrome: A randomized study of efficacy

Subacromial impingement syndrome: a survey of Italian physiotherapists and orthopaedics on diagnostic strategies and management modalities

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