Shoulder Impingements

Subacromial impingement resulting in bursa’s inflammation and friction on the tendonwww.howtorelief.com/shoulder-impingement-syndrome-symptoms-causes-diagnosis-treatment/

Subacromial impingement resulting in bursa’s inflammation and friction on the tendon

www.howtorelief.com/shoulder-impingement-syndrome-symptoms-causes-diagnosis-treatment/

Sub-acromial impingement

  • Most common cause of shoulder pain

  • combination of extrinsic factors (Coraco-acromial ligament, AC joint, anterioracromion) and intrinsic factors (degeneration of the supra-spinatous, causing the ascenssion of the humeral head.

  • Patients usually suffer from pain, especially in over-head activities

  • Xrays and MRI are generally required.

  • First line treatment: MEDICAL : NSAIDs, physiotherapie, sling, infiltration

  • Surgery (if medical treatment fails): subacromial decompression / acromioplasty +/- rotator cuff repair if needed.

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Subcoracoid impingement

  • Subcoracoid impingement is defined as impingement of the subscapularis between the coracoid and lesser tuberosity, especially when the arm is in adduction,flexion, and internal rotation

  • Xray is needed.

  • CT scan obtained with the arms crossed on chest is helpful to make the diagnosis: a coracohumeral distance of < 6 mm is considered abnormal (normal is 8.7 mm in the adducted arm 6.7 mm in the flexed arm)

  • MRI is useful to evaluate the rotator cuff condition

  • Corticoid + Xylocaine local injection can make the diagnosis.

  • First line treatment: conservative : NSAIDs, physiotherapie, infiltration

  • If failure, surgery is required for coracoplasty +/- subscapularis repair (open or under arthroscopie)