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Shoulder impingement syndrome. A critical review
F H Fu1, C D Harner, A H Klein
1Albert B. Ferguson, Jr., M.D. Laboratory for Orthopaedic Research, University of Pittsburgh School of Medicine, PA 15261.
Clinical Orthopaedics and Related Research
|August 1, 1991
Summary
Shoulder impingement syndrome, often causing anterior shoulder pain, can lead to rotator cuff tendinitis (RCT) and rupture. Differentiating primary and secondary RCT etiologies is crucial for effective treatment planning.
Area of Science:
- Orthopedics
- Sports Medicine
- Pathology
Background:
- Impingement syndrome is a common cause of anterior shoulder pain, particularly during overhead activities.
- It encompasses various shoulder disorders with a shared pathological pathway, including rotator cuff tendinitis (RCT).
- Untreated RCT can progress to rotator cuff rupture.
Purpose of the Study:
- To differentiate between the two distinct etiologies of rotator cuff tendinitis (RCT).
- To highlight the importance of distinguishing these etiologies for effective treatment planning.
- To underscore the need for further research into the microscopic pathology of RCT.
Main Methods:
- Review of existing literature and clinical practice information.
- Analysis of the common pathological course of impingement syndrome and RCT.
- Identification of distinct etiological factors for RCT.
Main Results:
- Impingement syndrome involves disorders leading to anterior shoulder pain and potentially rotator cuff tendinitis (RCT) and rupture.
- Two distinct etiologies of RCT exist: primary impingement (common in nonathletes) and secondary mechanical impingement (common in athletes due to instability).
- Differentiating these etiologies is vital for appropriate treatment strategies.
Conclusions:
- Understanding the distinct etiologies of rotator cuff tendinitis is essential for successful treatment of shoulder impingement syndrome.
- Primary impingement is linked to the coracoacromial arch, while secondary impingement arises from instability in overhead sports.
- Further investigation into the microscopic pathology of RCT is warranted.