Impingement syndrome - Revision history

Rossdonaldson1: /* Background */

2020-05-21T20:37:01Z

Background

← Older revision		Revision as of 20:37, 21 May 2020
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	==Background==		==Background==
			[[File:Shoulder_joint_back-en.png\|thumb\|Shoulder anatomy, anterior.]]
			[[File:Shoulder joint back 05r4v.png\|thumb\|Shoulder anatomy, posterior.]]
	*Refers to [[subacromial bursitis]], rotator cuff tendinitis, supraspinatus tendinitis, and painful arc syndrome		*Refers to [[subacromial bursitis]], rotator cuff tendinitis, supraspinatus tendinitis, and painful arc syndrome
	**All are due to repetitive subacromial impingement due to overhead use of the arm		**All are due to repetitive subacromial impingement due to overhead use of the arm

2019-10-18T17:09:27Z

Clinical Features

← Older revision		Revision as of 17:09, 18 October 2019
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	**Exacerbated by activities that require overhead arm use		**Exacerbated by activities that require overhead arm use
	**Night pain		**Night pain

			===Impingement Tests===
			*Maneuver of Neer
			**Prevent scapular rotation with one hand while raising patient's straightened arm in full forward flexion to overhead
			**Positive sign is pain in the arc between 70-120'
			*Hawkins Impingement Test
			**Position the shoulder at 90' of abduction and elbow at 90' of flexion
			**Then rotate shoulder internally bringing the arm across the front of the pt
			**Positive sign is pain during this maneuver

	==Differential Diagnosis==		==Differential Diagnosis==

2019-10-18T16:29:16Z

← Older revision		Revision as of 16:29, 18 October 2019
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	==Background==		==Background==
	*Refers to subacromial bursitis, rotator cuff tendinitis, supraspinatus tendinitis, and painful arc syndrome		*Refers to [[subacromial bursitis]], rotator cuff tendinitis, supraspinatus tendinitis, and painful arc syndrome
	**All are due to repetitive subacromial impingement due to overhead use of the arm		**All are due to repetitive subacromial impingement due to overhead use of the arm
	*Shoulder range of motion should be intact		*Shoulder range of motion should be intact
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	**Chronic aching pain with daily activities and night pain		**Chronic aching pain with daily activities and night pain
	*Stage 3		*Stage 3
	**Rotator cuff tear		**[[Rotator cuff tear]]
	**Often requires surgical decompression of the subacromial space		**Often requires surgical decompression of the subacromial space

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	**Exacerbated by activities that require overhead arm use		**Exacerbated by activities that require overhead arm use
	**Night pain		**Night pain

			==Differential Diagnosis==
			{{Shoulder DDX}}

	==Evaluation==		==Evaluation==
	*See [[Shoulder (Tests)]]		*See [[Shoulder (Tests)]]

	~~==Differential Diagnosis==~~
	~~{{Shoulder DDX}}~~

	==Management==		==Management==

2019-05-10T01:30:30Z

References

2016-07-23T13:45:46Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-14T02:51:37Z

Disposition

← Older revision		Revision as of 02:51, 14 July 2016
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	==Disposition==		==Disposition==
	*Refer to primary care within 2 weeks		*Refer to primary care provider within 2 weeks

	==References==		==References==

2016-07-14T00:49:54Z

Disposition

← Older revision		Revision as of 00:49, 14 July 2016
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	==Disposition==		==Disposition==
	*Refer to ~~PMD~~ within 2 weeks		*Refer to primary care within 2 weeks

	==References==		==References==

2016-07-14T00:49:44Z

Management

← Older revision		Revision as of 00:49, 14 July 2016
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	*Relative rest and activity modification		*Relative rest and activity modification
	**Avoid the aggravating activity and minimize all overhead activities		**Avoid the aggravating activity and minimize all overhead activities
	*NSAIDs and opioids as needed for pain		*[[NSAIDs]] and [[opioids]] as needed for pain
	*Cryotherapy		*Cryotherapy
	**Apply ice to affected shoulder for 10-15min TID-QID		**Apply ice to affected shoulder for 10-15min TID-QID

2016-07-11T18:22:47Z

Text replacement - " w/ " to " with "

← Older revision		Revision as of 18:22, 11 July 2016
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	**Edema and hemorrhage advance to rotator cuff tendinitis		**Edema and hemorrhage advance to rotator cuff tendinitis
	**Prolonged pain (weeks to months) or recurrence of symptoms		**Prolonged pain (weeks to months) or recurrence of symptoms
	**Chronic aching pain w/ daily activities and night pain		**Chronic aching pain with daily activities and night pain
	*Stage 3		*Stage 3
	**Rotator cuff tear		**Rotator cuff tear
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	*Range of motion exercises		*Range of motion exercises
	**Pendulum swings		**Pendulum swings
	***Patient bends slightly at waist w/ arm hanging freely in front of body		***Patient bends slightly at waist with arm hanging freely in front of body
	***Arms should be swung in gentle arcs of motion both clockwise and counter-clockwise		***Arms should be swung in gentle arcs of motion both clockwise and counter-clockwise
	***Swing to level of pain tolerance x 5-10min TID-QID		***Swing to level of pain tolerance x 5-10min TID-QID

2016-07-08T04:27:08Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 04:27, 8 July 2016
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	{{Shoulder DDX}}		{{Shoulder DDX}}

	==~~Treatment~~==		==Management==
	*Relative rest and activity modification		*Relative rest and activity modification
	**Avoid the aggravating activity and minimize all overhead activities		**Avoid the aggravating activity and minimize all overhead activities