scholarly journals Subacromial impingement syndrome

2012 ◽  
Vol 4 (2) ◽  
pp. 18 ◽  
Author(s):  
Masood Umer ◽  
Irfan Qadir ◽  
Mohsin Azam

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 has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patients, surgery. No high-quality RCTs 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.

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052092
Author(s):  
Joshua R Zadro ◽  
Zoe A Michaleff ◽  
Mary O'Keeffe ◽  
Giovanni E Ferreira ◽  
Romi Haas ◽  
...  

ObjectivesExplore how people perceive different labels for rotator cuff disease in terms of words or feelings evoked by the label and treatments they feel are needed.SettingWe performed a content analysis of qualitative data collected in a six-arm, online randomised controlled experiment.Participants1308 people with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomised to one of six labels: subacromial impingement syndrome, rotator cuff tear, bursitis, rotator-cuff-related shoulder pain, shoulder sprain and episode of shoulder pain.Primary and secondary outcomesParticipants answered two questions (free-text response) about: (1) words or feelings evoked by the label; (2) what treatments they feel are needed. Two researchers iteratively developed coding frameworks to analyse responses.Results1308/1626 (80%) complete responses for each question were analysed. Psychological distress (21%), uncertainty (22%), serious condition (15%) and poor prognosis (9%) were most often expressed by those labelled with subacromial impingement syndrome. For those labelled with a rotator cuff tear, psychological distress (13%), serious condition (9%) and poor prognosis (8%) were relatively common, while minor issue was expressed least often compared with the other labels (5%). Treatment/investigation and surgery were common among those labelled with a rotator cuff tear (11% and 19%, respectively) and subacromial impingement syndrome (9% and 10%) compared with bursitis (7% and 5%).ConclusionsWords or feelings evoked by certain labels for rotator cuff disease and perceived treatment needs may explain why some labels drive management preferences towards surgery and imaging more than others.


2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Jean-Christophe Murray ◽  
Stéphane Pelet

Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.


2019 ◽  
Vol 25 (3) ◽  
pp. 57-66
Author(s):  
D. A. Malanin ◽  
A. I. Norkin ◽  
A. S. Tregubov ◽  
M. V. Demeshchenko ◽  
L. L. Cherezov

Relevance. Owing to its controlling action on the inflammatory process, pain-relieving and reparative effects the RPR-therapy became quite demanded for treatment of certain types of tendinopathies specified by prevalence of degenerative process and poor reparative potential. Purpose of the study — to evaluate the efficiency of PRP-therapy in patients with tendinopathies of rotator cuff (RC) long head of biceps (LHB) tendons. Material and Methods. The paper presents the results of two-center prospective study for application of autologous platelet rich plasma in treatment of 122 patients: 53 men and 69 women aging 46.8±6.8 years who suffered RC tendinopathy (66%), subacromial impingement syndrome and RC tendinopathy (17%) and LHB tendinopathy (17%). Treatment outcomes were evaluated in 1, 3 and 6 months after PRP-therapy using various scales — VAS, UCLA , DASH, — and instrumental examination methods (US, MRI). Results. The authors observed statistically significant improvement in pain and functional scores in all three groups as compared to reported scores prior to PRP-therapy during 6 months follow up. During this period of evaluation, the scores of UCLA and DASH in patients with RC tendinopathy improved at 8.6 and 36.4 points, with subacromial impingement syndrome and RC tendinopathy — at 9.6 and 38.8 points, with LHB tendinopathy — at 11.5 and 44.1 point, respectively. The most notable reduction of pain syndrome by VAS was achieved in treatment of LHB tendinopathy (at 5.4 points) and RC tendinopathy (at 5.2 point). The highest average scores of satisfaction with treatment outcomes were reported in patients with RC tendinopathy (2.3) and LHB tendinopathy (2.2). MRI and ultrasound examinations after PRP-therapy demonstrated improved structure of RC and LHB tendons — decreased or eliminated swelling, areas of hypoechoic signal. Conclusion. PRP-therapy in patients with RC and LHB tendons and with subacromial impingement syndrome with RC tendinopathy significantly reduces severity of pain and improved the shoulder joint function with positive dynamics during 6 months follow up.


2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110098
Author(s):  
Matthew Y. Siow ◽  
Brendon C. Mitchell ◽  
Michael Hachadorian ◽  
Wilbur Wang ◽  
Tracey Bastrom ◽  
...  

Background: Superior humeral migration has been established as a component of rotator cuff disease, as it disrupts normal glenohumeral kinematics. Decreased acromiohumeral interval (AHI) as measured on radiographs has been used to indicate rotator cuff tendinopathy. Currently, the data are mixed regarding the specific rotator cuff pathology that contributes the most to humeral head migration. Purpose: To determine the relationship between severity of rotator cuff tears (RCTs) and AHI via a large sample of magnetic resonance imaging (MRI) shoulder examinations. Study Design: Cohort study; Level of evidence, 3. Methods: A search was performed for 3-T shoulder MRI performed in adults for any indication between January 2010 and June 2019 at a single institution. Three orthopaedic surgeons and 1 musculoskeletal radiologist measured AHI on 2 separate occasions for patients who met the inclusion criteria. Rotator cuff pathologies were recorded from imaging reports made by fellowship-trained musculoskeletal radiologists. Results: A total of 257 patients (mean age, 52 years) met the inclusion criteria. Of these, 199 (77%) had at least 1 RCT, involving the supraspinatus in 174 (67.7%), infraspinatus in 119 (46.3%), subscapularis in 80 (31.1%), and teres minor in 3 (0.1%). Full-thickness tears of the supraspinatus, infraspinatus, or subscapularis tendon were associated with significantly decreased AHI (7.1, 5.3, and 6.8 mm, respectively) compared with other tear severities ( P < .001). Having a larger number of RCTs was also associated with decreased AHI (ρ = –0.157; P = .012). Isolated infraspinatus tears had the lowest AHI (7.7 mm), which was significantly lower than isolated supraspinatus tears (8.9 mm; P = .047). Conclusion: Although various types of RCTs have been associated with superior humeral head migration, this study demonstrated a significant correlation between a complete RCT and superior humeral migration. Tears of the infraspinatus tendon seemed to have the greatest effect on maintaining the native position of the humeral head. Further studies are needed to determine whether early repair of these tears can slow the progression of rotator cuff disease.


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