Rotator Cuff Impingement Syndrome
- Compression of rotator cuff tendons and subacromial bursa between the humeral head and the structures comprising the coracoacromial arch and proximal humerus
- Most common cause of atraumatic shoulder pain in patients >25 years of age
- Primary symptom is pain that is most severe when the arm is abducted between 60 and 120 degrees (the “painful arc”).
- Classically divided into three stages:
- Stage I: acute inflammation, edema, or hemorrhage of the underlying tendons due to overuse (typically in those age <25 years)
- Stage II: progressive tendinosis that leads to partial rotator cuff tear along with underlying thickening or fibrosis of surrounding structures (commonly, ages 25 to 40 years)
- Stage III: full-thickness tear (typically in patients age >40 years)
- Shoulder pain accounts for 1% of all primary care visits.
- Peak incidence of 25/1,000 patients per year occurs in patients aged 42 to 46 years.
- Impingement responsible for 18–74% of shoulder pain diagnoses
Prevalence of shoulder pain in general population ranges from ~7% to 30%.
- Repetitive overhead motions (throwing, swimming)
- Glenohumeral joint instability or muscle imbalance
- Acromioclavicular arthritis or osteophytes
- Thickened coracoacromial ligament
- Shoulder trauma
- Increasing age
- Proper throwing and lifting techniques
- Proper strengthening to balance rotator cuff and scapula stabilizer muscles
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Domino, Frank J., et al., editors. "Rotator Cuff Impingement Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome.
Rotator Cuff Impingement Syndrome. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome. Accessed June 2, 2023.
Rotator Cuff Impingement Syndrome. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome
Rotator Cuff Impingement Syndrome [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 02]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Rotator Cuff Impingement Syndrome ID - 116536 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome PB - Wolters Kluwer ET - 27 DB - 5-Minute Clinical Consult DP - Unbound Medicine ER -