The comparison of the radiological and clinical findings of subacromial impingement of the shoulder

Authors: A Gupta & L Funk

References: London: British Elbow and Shoulder Society, 2007.

Abstract
The radiological changes associated with subacromial impingement of the shoulder has been well described, but their correlation with the clinical findings is not known.

AIMS: To compare the radiological findings with the clinical diagnosis in 64 patients presenting with shoulder pain.

METHODS: In a retrospective study, the data of 33 patients with the clinical diagnosis of subacromial impingement and 31 patients without impingement was analysed. Patients with rotator cuff tears were excluded. Clinical and operative findings were recorded and a Consultant shoulder surgeon blinded to the clinical diagnosis reviewed standardised radiographs in three views. Radiographic views included Anterior-Posterior (AP), Axillary and Supraspinatus Outlet Views

RESULTS: On AP radiographs, radiological signs that correlated well with impingement included Acromial spur, Sourcil Sign, Greater Tuberosity Irregularity and Greater Tuberosity Cysts. Signs of impingement on Axillary and Supraspinatus Outlet Views did not correlate with clinical findings.

CONCLUSIONS: A positive correlation exists between the clinical and radiological findings of impingement, with radiological signs on AP radiographs being the most significant.