Impingement syndrome

As Impingement Syndrome (English " collision " ) is referred to in orthopedics and trauma surgery a functional impairment of joint mobility. It is produced mostly by degeneration or herniation of capsule or tendon material.

The term is mainly used for the shoulder. Degeneration or injury of the rotator cuff ( rotator cuff ) are the most common cause here. Affected patients may, due to the increasing entrapment of the supraspinatus to lift the arm barely above shoulder height. The actual impingement subacromial arises, ie below the acromioclavicular joint, which is why here of Subacromialsyndrom (short: SAS) is spoken.

The term but also for other joints, particularly the hip joint, in use. When the hip is usually a femoro - acetabuläres impingement, by the incongruities of the femoral head (caput femoris) and hip socket ( acetabulum ) is concluded. A distinction is made pincers or pincer impingement and the cam shaft or cam impingement in the hip. The former is based on the joint socket and mainly affects women. The latter is too large femoral head based and occurs more often in men.

Causes

The term impingement describes the disease process, as the pathological joint changes come through strong and jerky movements about, where it comes in the joint to " clashes " anatomical structures.

Clinical picture

Typically the impingement syndrome of the shoulder is a pain in abduction ( abduction ) of the upper arm in the range of 70 ° to 130 ° ( "painful arc" ), but also the external and internal rotation in the shoulder are more or less restricted strong. Diagnosis here a positive Neer sign is required. In this case, the maximally pronated arm is passively raised with a fixed shoulder blade. Pain from 130 ° are considered positive and interpreted as a sign for the presence of impingement. Furthermore, an irritation of the supraspinatus supraspinatus can also be achieved by maximum internal rotation with simultaneous abduction of the arm. This sign Jobe 's called Signed

More Impingementsyndrome are described for the elbow, the wrist, the hip, the knee and the ankle.