Subacromial space disorders: Clinical features and therapeutic indications

The causes and physiopathological aspects of the acromiohumeral impingement syndrome are described, and the anatomicopathological and anatomicoclinical classifications of rotator cuff damage proposed in the literature are presented. Clinical diagnosis is based on manoeuvres showing whether or not the syndrome is associated with a cuff tear. Stress is laid on the importance of instrumental diagnosis from A-R projections and the outlet view, as well as ultrasonography and MRI, both of which are highly sensitive and specific. Several methods of surgical (open and arthroscopic) and noninvasive treatment based on age, level of activity the existence and extent of a cuff tear, and the concomitance of other glenohumeral joint disorders are described, and an account is given of the appropriate surgical techniques