Klassifikation des Impingement-Syndroms nach Neer

Anwendung
Impingement-Syndrom

Stage I
(Edema and hemorrhage)
Typical age

<25
 Diff. diagnosis Subluxation, A/C arthritis
 Characteristics After excessive overhead use in sports or work.
Good prognosis
 Clinical courseReversible
 Treatment Conservative
   
Stage II
(Fibrosis and tendinitis)
Typical age25-40
 Diff. diagnosis Frozen shoulder, calcium
 Characteristics After vigorous overhead use.
Bursa may become fibrotic and thickened
 Clinical courseRecurrent pain with activity
 Treatment Consider bursectomy; C/A ligament division
   
Stage III
(Bone spurs and tendon rupture. Tears of the rotator cuff, biceps ruptures)
Typical age

>40
 Diff. diagnosis Cervical radiculitis; neoplasm
 Characteristics Incomplete or complete tears of the rotator cuff,
biceps lesions, and alterations at the anterior
acromion and greater tuberosity may occur.
Tears of the supraspinatus occur before
biceps ruptures of a ratio of approximately
7: 1 . Routine roentgenograms are often negative
 Clinical courseProgressive disability
 Treatment Anterior acromioplasty; rotator cuff repair