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Rotator Cuff Impingement Syndrome

Rotator Cuff Impingement Syndrome is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • 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)

Epidemiology

Incidence
  • Shoulder pain accounts for 1% of all primary care visits.
  • Peak incidence of 25/1,000 patients/year occurs in patients aged 42 to 46 years.
  • Impingement responsible for 18–74% of shoulder pain diagnoses

Prevalence
Prevalence of shoulder pain in general population ranges from ~7% to 30%.

Risk Factors

  • Repetitive overhead motions (throwing, swimming)
  • Glenohumeral joint instability or muscle imbalance
  • Acromioclavicular arthritis or osteophytes
  • Thickened coracoacromial ligament
  • Shoulder trauma
  • Increasing age
  • Smoking

General Prevention

  • Proper throwing and lifting techniques
  • Proper strengthening to balance rotator cuff and scapula stabilizer muscles

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Citation

Stephens, Mark B., et al., editors. "Rotator Cuff Impingement Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome.
Rotator Cuff Impingement Syndrome. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome. Accessed March 19, 2019.
Rotator Cuff Impingement Syndrome. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome
Rotator Cuff Impingement Syndrome [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 March 19]. Available from: https://im.unboundmedicine.com/medicine/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 - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116536/all/Rotator_Cuff_Impingement_Syndrome PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -