• Journal of radiological science and technology
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• v.23 no.1
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• pp.21-27
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• 2000

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior $30^{\circ}$ caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x - ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.1
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• pp.85-94
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• 2012

Objectives: The Purpose of this study is to investigate the clinical application of Geumchuldodam-tang(Q$\acute{i}$nzhud$\check{a}$ot$\acute{a}$n-tang) to three patients with shoulder impingement syndrome. Methods: Patients were hospitalized at Dept. of Oriental Rehabilitation Medicine, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as shoulder impingement syndrome and treated mainly with herbal medicine, Geumchuldodam-tang(Q$\acute{i}$nzhud$\check{a}$ot$\acute{a}$n-tang). This study was measured by Numeric Rating Scale(NRS) score. Results: After taking Geumchuldodam-tang(Q$\acute{i}$nzhud$\check{a}$ot$\acute{a}$n-tang), pain of the patients was controlled. NRS scores were decreased. Conclusions: As seen in these three cases of shoulder impingement syndrome, Geumchuldodam-tang(Q$\acute{i}$nzhud$\check{a}$ot$\acute{a}$n-tang) has a positive effect to control pain with shoulder impingement syndrome.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.99-105
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• 1999

We investigated the effectiveness of arthroscopic decompression in stage Ⅱ subacromial impingement after long term follow up. Arthroscopic subacromial decompression was done in 104 consecutive patients who had stage Ⅱ sub­acromial impingement. After average of 8.4 years follow up, the final results were as following; 57 shoulders(55%) in excellent, 25(24%) in good, 16(15%) in fair and 6(6%) in poor. All parameters-pain, function, muscle strength and motion-were improved significantly(p<0.00l). Rotator cuff tear was developed in 10 shoulders after decompression. Among them, 8 shoulders had unfavorable results including two poor. In 6 failures, two had rotator cuff tear, three had recurrence of impingement with degenerative change and reflex sympathetic dystrophy was developed in one. Reoperations were done in 4 shoulders. Improvement of impingement symptoms was maintained in the most of patients(79%) after long term follow up. Arthroscopic decompression surgery was very effective means for stage Ⅱ impingement syndrome.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.35-40
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• 1999

Impingement syndrome is caused by a conflictual status between rotator cuff, subacromial bursa and anatomic and functional coracoacromial arch. The purpose of this study was to assessment the coracoacromial arch by MRI and to determine major factors among five components of coracoacromial arch. We analyzed forty-two cases of clinical impingement sign and test positive and postoperative confirmed diagnosed from March, 1991 to January, 1999. We evaluated acromial end abnormality according to the Bigliani acromial type and formation of osteophyte. Clavicular end abnormality classified flat, outward protrusion, inward protrusion to coracoacromial arch. Acromioclavicular joint abnormalities were advanced osteoarthritis and positive signal change. Coracoacromial ligament thickening was above 2 mm in oblique sagittal image. Coracoid process abnormality was inward protrusion to coracoacromial arch. All consecutive patients abnormalities were as follows: clavicular end osteophyte formation and inward protrusion to coracoacrmial arch were 30%, acromial end osteophyte formation was 28%, advanced acromioclavicular joint arthritis and osteophyte formation were 56%, coracoacromial ligament thickening was 24% and no coracoid process inward protrusion to coracoacromial arch. Impingement syndrome combined with rotator cuff tear group abnormalities were clavicular end(40%), acromial end(40%), acromioclavicular joint(20%), coracoacromialligament(20%) and coracoid process abnormality(0%) respectively. Only impingement syndrome group abnormalities were clavicular end(25%), acromial end(31%), acromioclavicular joint(62%), coracoacromial ligament(25%) and coracoid process(0%) respectively. Acromial type I(flat) were 6 cases, type II(curved) were 26 cases and type III(hooked) were 10 cases. We concluded that the most important contributing factors for impingement syndrome was acromial type and second was acromioclavicular joint arthritis and bony spur formation.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.101-111
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• 2020

Purpose : The purpose of this study was to identify the comparison of the effects of manual therapy combined with exercise on range of motion (ROM), muscle strength, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. Methods : The subjects were 30 patients diagnosed with impingement syndrome of the shoulder. Thirty subjects are randomly assigned to each 3 different groups; Group 1. (exercise group), Group 2. (exercise+mobilization; EMOB group), Group 3. (exercise+mobilization with movement; EMWM group). The interventions were performed three times a week for 4 weeks. The main outcome measures were goniometer, Biodex dynamometer, and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), muscle strength (external and internal rotation: 60 °/sec., 180 °/sec.), and functional performance were compared among the groups. Results : No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal and total rotation was significantly increased in Group 2, 3 compared to Groups 1. Muscle strength of external and internal rotation (60 °/sec., 180 °/sec.) was not significantly different among Group 1, 2, 3, and functional performance was significantly increased in Group 2, 3 compared to Group 1. However, there was no significant difference between Group 2 and Group 3 in all measurements. Conclusion : An intervention with manual therapy such as EMOB and EMWM was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance. However, further efforts are needed to identify effects of specific interventions with manual therapy.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.103-107
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• 2012

This study was performed to design a modified Y-View as an imaging method for the Y-View in supine position for patients who requires Y-View imaging for the diagnosis of shoulder impingement syndrome but having trouble for the positioning of patients complaining of shoulder pain. On the result of comparative analysis of the images obtained by changing the lateral-medio degree of X-ray tube into $35^{\circ}$, $40^{\circ}$, and $45^{\circ}$ while patient is in supine position, $40^{\circ}$ of X-ray tube in lateral-medio direction produced the most valuable image for the diagnosis by best describing the shapes of acromion, clavicle space, and coracoacromial arch. Therefore, patients who have difficulty in Y-View position to obtain Y-View image, modified Y-View can be applied as a useful alternative method. By this study, various applications not only in shoulder impingement syndrome but also in diverse omarthralgia diseases are expected.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.11a
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• pp.253-268
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• 2004

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2003.03a
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• pp.93-93
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• 2003

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1995.03a
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• pp.48-50
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• 1995

• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.186-190
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• 2001

Purpose: The aim of this study was to investigate the diagnostic accuracy of Neer, Hawkins provocative tests and supraspinatus manual muscle test for the assessment of impingement syndrome, partial tear and small complete tear of De rotator cuff. Materials and Methods: Seventy-one female and 115 male patients were included in the study. Patients were divided into four groups of no impingement, impingement without tear, partial tear and small complete tear of the rotator cuff, which were confirmed by sonogram, magnetic resonance imaging and surgery. Neer and Hawkins provocative tests and supraspinatus manual muscle test were performed respectively. SAS 6.12 version was used in statistical analysis. Results: We found that Neer test had 94% sensitivity, 54% specificity for impingement without tear and 89% sensitivity, 78% specificity for partial tear and 96% sensitivity, 23% specificity for small tear. Hawkins test revealed 95% sensitivity, 54% specificity for impingement without tear and 93% sensitivity, 78% specificity for partial tear and 100% sensitivity, 23% specificity for small tear. Supraspinatus manual muscle test revealed 27% sensitivity, 94% specificity for impingement without tear and 29% sensitivity, 82% specificity for partial tear and 48% sensitivity, 82% specificity for small tear. Conclusion: Neer and Hawkins tests have high sensitivity, low specificity for impingement syndrome, partial and small tear. Supraspinatus manual muscle test had low sensitivity and high specificity. However this test was not effective to differentiate the partial and small rotator cuff tear. We thought that more effective provocative test should be designed to detect the partial and small rotator cuff tear.