Subacromial impingement

Discussion:

Subacromial impingement should not be diagnosed solely off a plain radiograph and should be considered clinically 1; this particular case was clinically correlated and diagnosed.

Physical examination includes the investigation of three signs firstly, the Neer sign (pain on forced flexion) secondly, the Hawkings sign (pain on internal rotation with arm elevated to 90 degrees) and thirdly, the Neer injection test (less pain during the Neer sign after a local injection). However, the sensitivity of these physical examinations is disputed in the literature 3.

It is one of the most common forms of shoulder impingement; it accounts for 44-65% of shoulder complaints 2.

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