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Shoulder Impingement Syndrome.

Evan H Horowitz1, William R Aibinder2

  • 1Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, MSC 30, Brooklyn, NY 11203, USA. Electronic address: https://twitter.com/EvanHorowitzMD.

Physical Medicine and Rehabilitation Clinics of North America
|April 1, 2023
PubMed
Summary
This summary is machine-generated.

Shoulder impingement, a common cause of shoulder pain, is better understood when subcategorized. Evaluation and treatment involve history, physical exam, imaging, and conservative therapies, with surgery for persistent cases.

Keywords:
AcromionBursitisImpingementRotator cuffShoulderSubacromialSubcoracoid

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Musculoskeletal Disorders

Background:

  • Shoulder impingement is a frequent cause of shoulder pain.
  • The term "shoulder impingement syndrome" is considered vague and nonspecific.
  • It can be accurately subcategorized into subacromial, internal, and subcoracoid impingement.

Purpose of the Study:

  • To clarify the diagnostic and treatment approaches for shoulder impingement.
  • To emphasize the importance of subcategorization for accurate diagnosis and management.
  • To provide an overview of the evaluation and treatment algorithm for different types of shoulder impingement.

Main Methods:

  • Review of diagnostic criteria and treatment strategies for shoulder impingement.
  • Emphasis on thorough patient history and focused physical examination.
  • Inclusion of standard radiographs and advanced imaging (MRI, ultrasound) in evaluation.
  • Discussion of conservative treatments: physical therapy, medications, and injections.
  • Outline of surgical options for refractory cases: decompression, debridement, and repair.

Main Results:

  • Subcategorization of shoulder impingement (subacromial, internal, subcoracoid) provides a more precise diagnosis.
  • A consistent evaluation and treatment algorithm is applicable across these subcategories.
  • Conservative management is the primary treatment modality.
  • Surgical intervention is reserved for cases unresponsive to conservative treatments.

Conclusions:

  • Accurate diagnosis and management of shoulder pain require subcategorizing impingement.
  • A systematic approach involving clinical evaluation, imaging, and stepwise treatment is effective.
  • Conservative treatments form the cornerstone of management, with surgery as a last resort.