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Rotator Cuff Impingement
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Subacromial impingement syndrome (SIS/SAIS)
            • Anterior subacromial impingement syndrome (ASIS)
          • Synonyms

            • External impingement, extrinsic impingement, supraspinatus (SS) impingement, outlet impingement, classic impingement
          • Definitions

            • Painful compression of SS tendon and subacromial (SA) bursa between coracoacromial (CA) arch and humeral head
              • CA arch
                • Anterior acromion process
                • CA ligament
                • Acromioclavicular (AC) joint
                • Inferior border of outlet is humeral head
              • Older individuals
              • Most commonly diagnosed shoulder disease

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          • Reporting Tips

                                            Selected References

                                            1. Gammaitoni AR et al: Predicting response to subacromial Injections and lidocaine/tetracaine patch from pretreatment pain quality in patients with shoulder impingement syndrome. Pain Med. 16(7):1333-40, 2015
                                            2. Rhon DI et al: Management of the unilateral shoulder impingement syndrome. Ann Intern Med. 162(3):237-8, 2015
                                            3. Tasaki A et al: Quantitative and qualitative analyses of subacromial impingement by kinematic open MRI. Knee Surg Sports Traumatol Arthrosc. 23(5):1489-97, 2015
                                            4. Kanatli U et al: The role of radiological subacromial distance measurements in the subacromial impingement syndrome. Eur J Orthop Surg Traumatol. 23(3):317-22, 2013
                                            5. Tuite MJ: Magnetic resonance imaging of rotator cuff disease and external impingement. Magn Reson Imaging Clin N Am. 20(2):187-200, ix, 2012
                                            6. Campbell RS et al: External impingement of the shoulder. Semin Musculoskelet Radiol. 12(2):107-26, 2008
                                            7. Hambly N et al: Rotator cuff impingement: correlation between findings on MRI and outcome after fluoroscopically guided subacromial bursography and steroid injection. AJR Am J Roentgenol. 189(5):1179-84, 2007
                                            8. Brossmann J et al: Shoulder impingement syndrome: influence of shoulder position on rotator cuff impingement--an anatomic study. AJR Am J Roentgenol. 167(6):1511-5, 1996
                                            9. Fu FH et al: Shoulder impingement syndrome. A critical review. Clin Orthop Relat Res. (269):162-73, 1991
                                            10. Seeger LL et al: Shoulder impingement syndrome: MR findings in 53 shoulders. AJR Am J Roentgenol. 150(2):343-7, 1988
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Subacromial impingement syndrome (SIS/SAIS)
                                                      • Anterior subacromial impingement syndrome (ASIS)
                                                    • Synonyms

                                                      • External impingement, extrinsic impingement, supraspinatus (SS) impingement, outlet impingement, classic impingement
                                                    • Definitions

                                                      • Painful compression of SS tendon and subacromial (SA) bursa between coracoacromial (CA) arch and humeral head
                                                        • CA arch
                                                          • Anterior acromion process
                                                          • CA ligament
                                                          • Acromioclavicular (AC) joint
                                                          • Inferior border of outlet is humeral head
                                                        • Older individuals
                                                        • Most commonly diagnosed shoulder disease

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  • Image Interpretation Pearls

                                                                                    • Reporting Tips

                                                                                      Selected References

                                                                                      1. Gammaitoni AR et al: Predicting response to subacromial Injections and lidocaine/tetracaine patch from pretreatment pain quality in patients with shoulder impingement syndrome. Pain Med. 16(7):1333-40, 2015
                                                                                      2. Rhon DI et al: Management of the unilateral shoulder impingement syndrome. Ann Intern Med. 162(3):237-8, 2015
                                                                                      3. Tasaki A et al: Quantitative and qualitative analyses of subacromial impingement by kinematic open MRI. Knee Surg Sports Traumatol Arthrosc. 23(5):1489-97, 2015
                                                                                      4. Kanatli U et al: The role of radiological subacromial distance measurements in the subacromial impingement syndrome. Eur J Orthop Surg Traumatol. 23(3):317-22, 2013
                                                                                      5. Tuite MJ: Magnetic resonance imaging of rotator cuff disease and external impingement. Magn Reson Imaging Clin N Am. 20(2):187-200, ix, 2012
                                                                                      6. Campbell RS et al: External impingement of the shoulder. Semin Musculoskelet Radiol. 12(2):107-26, 2008
                                                                                      7. Hambly N et al: Rotator cuff impingement: correlation between findings on MRI and outcome after fluoroscopically guided subacromial bursography and steroid injection. AJR Am J Roentgenol. 189(5):1179-84, 2007
                                                                                      8. Brossmann J et al: Shoulder impingement syndrome: influence of shoulder position on rotator cuff impingement--an anatomic study. AJR Am J Roentgenol. 167(6):1511-5, 1996
                                                                                      9. Fu FH et al: Shoulder impingement syndrome. A critical review. Clin Orthop Relat Res. (269):162-73, 1991
                                                                                      10. Seeger LL et al: Shoulder impingement syndrome: MR findings in 53 shoulders. AJR Am J Roentgenol. 150(2):343-7, 1988