Subacromial impingement syndrome

Abstract

Subacromial impingement syndrome (SAIS) represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a matter of debate. However, the etiology is multi-factorial, and it has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patients, surgery. No high-quality randomized controlled trials are available so far to provide possible evidence for differences in outcome of different treatment strategies. There remains a need for high-quality clinical research on the diagnosis and treatment of SAIS.

Association Between Subacromial Impingement and Acromiohumeral Distance on MRI

“…The subacromial space is defined by the humeral head inferiorly, the anterior border and undersurface of the anterior acromion, the coracoacromial ligament and the acromoclavicular joint superiorly. The distance between the acromion and the humeral head ranges from 1 to 1.5 cm in healthy subjects, as seen on plain radiography (2). Other studies have reported that the distance ranges from 0.6 to 1.4 cm in the neutral position (4).…”

“…Other studies have reported that the distance ranges from 0.6 to 1.4 cm in the neutral position (4). The supraspinatus tendon, long head of the biceps tendon, subdeltoid and subacromial bursa are interposed between the acromion and the humeral head (2). The coracoacromial ligament, a very hard structure, impinges the cuff, and is the upper main structure of the subacromial space.…”

“…SI is a very common disorder of the shoulder, accounting for 44% -45% of all shoulder pain (2,3). The subacromial space is defined by the humeral head inferiorly, the anterior border and undersurface of the anterior acromion, the coracoacromial ligament and the acromoclavicular joint superiorly.…”

“…Norwood et al reported that an AHD less than 7 mm on anteroposterior radiographs suggest a large rotator cuff tear (7). Others reported that narrowing of the AHD is associated with degeneration of the rotator cuff (2). These previous studies were mainly based on plain radiography.…”

The subacromial impingement syndrome of the shoulder: The role of physiotherapist in the evaluation and treatment of the syndrome

“…It is estimated that 7%-26% of the population in the uK will experience the syndrome [31]. a multivariate cause of the disease is due to modified and unmodified factors that appear individually or combined [22,24,32,71]. an unmodified factor is the anatomy of acromioclavicular joint [62], the presence of osteophytes, stenosis of subacromial area [24,32,48,62] and inadequate vascularization in the shoulder area [46].…”