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Pathology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Impingement may result from:

  • subacromial spurs
  • osteoarthritic thickening of the acromioclavicular joint
  • swelling of the cuff or subacromial bursa from systemic inflammatory disease such as rheumatoid arthritis or gout
  • prolonged, excessive or unaccustomed use of the shoulder in the impingement position

The effect of such impingement ranges from localised, self-limiting tendinitis, to the development of minute tears (which may be followed by scarring and calcification of the tendon), to partial or even full-thickness tearing of the cuff. Small tears of the cuff are almost universal after the age of 60.

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