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Sports Medicine
intermediate
X-Type

External Impingement - Subacromial Impingement, Neer Stages and Outlet View

Shoulder Pathology

A 52-year-old recreational tennis player presents with 6 months of anterolateral shoulder pain worsened by overhead activities. Examination reveals a positive Neer impingement sign (pain with passive forward flexion), positive Hawkins-Kennedy test, and painful arc between 60-120 degrees. Rotator cuff strength is intact. X-rays show type II acromion morphology. Regarding subacromial impingement syndrome:

Mark each as TRUE or FALSE

A

SUBACROMIAL IMPINGEMENT (external impingement) is mechanical compression of the supraspinatus tendon...

B

NEER STAGES: Stage I = edema and hemorrhage (age less than 25, reversible); Stage II = fibrosis and ...

C

External impingement only occurs in patients over 60 years old; Stage I always requires surgery; bon...

D

CLINICAL EXAMINATION: Neer impingement sign (passive forward flexion causes pain - 89% sensitive); H...

E

BIGLIANI ACROMION classification on outlet view: Type I = flat (17% association with cuff tears); Ty...

Answer the questions to see explanations

Click T (True) or F (False) for each option