shoulder impingement
TRANSCRIPT
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By Chris Pullen
Shoulder Impingement
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Clinical Features
• Pain– nocturnal ++– overhead activities– unable to sleep on involved side
• Painful arc (70-120°)• Impingement signs
– Neer– Hawkins
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Investigations 1
• Plain XR– AP, Lateral & Outlet view
• USS• MRI• Arthrogram• CT scan
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Investigations 2
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Investigations 3
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Investigations 4
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Management
• Non - operative– NSAID– Physiotherapy– Sub-acromial injection
• Operative– Open– Arthroscopic
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Non – Operative Treatment
• 3 month rehabilitation programme• Physiotherapy
– scapular muscle strengthening – posterior capsular stretching– US
• Success 33-92%
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Arthroscopic Treatment 2
Advantages• less surgical morbidity• decreased hospitalization time• quicker rehab• direct visualization of GH joint • smaller scar
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Arthroscopic Treatment 3
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Arthroscopic Treatment 4
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Arthroscopic Treatment 5
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Conclusion
• Common condition• Diagnosis usually made on examination
findings & XR ( not USS) • 3/12 of non-operative treatment may be
helpful• Arthroscopic techniques have significant
benefits when surgery is required
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THE END