RESEARCH ARTICLE


The Painful Shoulder: Shoulder Impingement Syndrome



Yousaf Khan*, Mathias Thomas Nagy, Joby Malal, Mohammad Waseem
Department of Trauma and Orthopaedic Surgery, Macclesfield District General Hospital, Victoria Road, Macclesfield, SK10 3BL, UK


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Creative Commons License
© Khan et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Trauma and Orthopaedic Surgery, Macclesfield District General Hospital, Victoria Road, Macclesfield, SK10 3BL, UK; Tel: 01625 661307; Fax: 01625 661436; E-mail: Yousaf.Khan@Nhs.net


Abstract

Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care.

The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma as it passes under the coracoacromial arch. However acute traumatic injuries may also lead to this condition.

Diagnosis remains a clinical one, however advances in imaging modalities have enabled clinicians to have an increased understanding of the pathological process. Ultrasound scanning appears to be a justifiable and cost effective assessment tool following plain radiographs in the assessment of shoulder impingment, with MRI scans being reserved for more complex cases.

A period of observed conservative management including the use of NSAIDs, physiotherapy with or without the use of subacromial steroid injections is a well-established and accepted practice. However, in young patients or following any traumatic injury to the rotator cuff, surgery should be considered early. If surgery is to be performed this should be done arthroscopically and in the case of complete rotator cuff rupture the tendon should be repaired where possible.

Keywords: Shoulder impingement syndrome, rotator cuff, arthroscopic subacromial decompression (ASAD).