Subacromial Impingement Syndrome Sybacromiaal Impingement Syndroom
Conditions
Interventions
Patients will be subjected to usual care treatment and diagnostics for shoulder complaints, including a standard MRI-arthrogram and radiographs.
Additionally, patients will be subject to non-invasiv
Sponsors
Leiden University Medical Center, Leiden, the Netherlands
Medical Center Haaglanden, the Hague, the Netherlands
Rijnland hospital, Leiderdorp, the Netherlands
Eligibility
Inclusion criteria
Inclusion criteria: The clinical diagnosis of stage I or II SIS is made when one or more of the following mentioned factors exist, next to a positive Neer impingement test and a positive Hawkins test. Patients’ history: 1. Diffuse unilateral shoulder pain for > 3 months; 2. Pain during activities with abduction, retroflexion and/or internal rotation (i.e. closing the door, putting on jacket, overhead activities); 3. Pain at night or incapable of lying on the shoulder. Physical examination: 1. Diffuse pain at palpation of the greater tuberosity; 2. Disturbed scapulohumeral rhythm; 3. Painful arc; 4. No complaints or sings of pathologies on the contralateral shoulder; 5. > 90 Degrees external rotation in 90 degrees of passive abduction (frozen shoulder); 6. Positive Yocum test.
Exclusion criteria
Exclusion criteria: Patients are excluded if one of the following characteristics is found: 1. 60 years old; 2. Restrictions in passive movements of glenohumeral joint/frozen shoulder; 3. History of fracture or dislocation of the shoulder; 4. History of surgery around the shoulder (in anamnesis); 5. Tumors; 6. No informed consent; 7. Clinical and radiographic signs of comorbidities or alternative diagnoses on the affected shoulder (glenohumeral instability, glenohumeral movement restriction, glenohumeral osteoarthritis or arthritis, rheumatic disorder, labrum lesions, a history of trauma on the affected shoulder, biceps muscle tendinitis, complete (full thickness) rotator cuff rupture, cervical radiculopathy, PASTA lesion, or calcifying tendinitis); 8. Contralateral shoulder with clinical signs of shoulder complaints; 9. Pacemaker or other electronic implants.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Cranial translation of the humerus as measured on AP-radiographs in rest, and with a constant abduction and adduction force exertion against an force transducer; 2. Scapulohumeral rhythm and shoulder-arm Range of Motion as measured with an electromagnetic motion tracking device. | — |
Secondary
| Measure | Time frame |
|---|---|
| All study parameters categorized for hypothesized etiological subgroups: 1. Relative cranial translation of the humerus: 3D arm-scapula motion registration (3D RoM), muscle activation parameters of shoulder and rotator cuff muscles (EMG), static acromiohumeral distance (sAH) on AP-radiographs ‘at rest’ and with exerted ab- and adduction moments (dAH), integrate bony 3D-shape with 3D RoM to describe dynamic AH (3DdAH); 2. Structural (bony) narrowing of the subacromial space: shape parameters of scapula (i.e. Bigliani acromion classification) and humerus, 3D kinematic analysis of scapulo-humeral motion by integration of bony 3D-shapes with 3D RoM; 3. Subacromial inflammatory processes and damaged tissues: MRI for rotator cuff and muscle quality (Goutallier score) and signs of bursitis, tendinitis and rotator cuff ruptures; 4. Other primary pathologies leading to SIS complaints: Evaluation of MRI and radiographs for acromioclavicular-osteoarthritis, full thickness rotator cuff-ruptures, coracoid impingement and other subacromial pathologies. | — |
Contacts
Public ContactP.B. Witte, de
PO Box 9600, postzone J-11-R
Outcome results
None listed