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[Postero-superior glenoid impingement. Another shoulder impingement].
G Walch1, J P Liotard, P Boileau
1Clinique de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Lyon-Sud, Pierre-Bénite.
Summary
Deep rotator cuff tears in young athletes can stem from impingement between the supraspinatus tendon and the glenoid. This specific impingement occurs during forceful throwing motions, leading to partial tendon tears.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Shoulder Arthroscopy
Background:
- Partial tears of the deep supraspinatus tendon are a common cause of shoulder pain in athletes.
- The etiology of these tears, particularly in young throwers, is multifactorial and requires precise diagnosis.
Observation:
- An impingement was identified between the deep supraspinatus tendon and the posterosuperior glenoid rim in a young athlete.
- This impingement occurred during specific movements: arm abduction-retropulsion and forced lateral rotation.
- Arthroscopic visualization confirmed the impingement and associated partial deep-side supraspinatus tendon tear.
Findings:
- The patient presented with mixed clinical signs, indicating both anterior shoulder instability and rotator cuff impairment.
- The observed impingement mechanism is distinct from traditional sub-acromial impingement (Neer impingement).
- Differential diagnoses considered include Neer impingement, anterior instability with secondary impingement, and the newly described posterosuperior glenoid impingement.
Implications:
- This finding suggests a specific impingement syndrome contributing to deep-side supraspinatus tears in throwing athletes.
- Understanding this mechanism is crucial for accurate diagnosis and targeted treatment of shoulder injuries in this population.
- Further research may elucidate the biomechanics and long-term consequences of posterosuperior glenoid impingement.