Semin Musculoskelet Radiol 2015; 19(03): 277-283
DOI: 10.1055/s-0035-1549321
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Microinstability and Internal Impingement of the Shoulder

Alpesh Mistry
1   Department of Radiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom
,
Rob S.D. Campbell
1   Department of Radiology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
28 May 2015 (online)

Abstract

Internal impingement refers to entrapment of the rotator cuff and capsulolabral structures between the glenoid and humeral head in certain positions of the shoulder. This may be a normal physiologic phenomenon. However, it may occur as a pathologic process, especially in sports with repetitive overhead activity. The two types of internal impingement are posterosuperior and anterosuperior, with established radiologic manifestations. These conditions were initially thought to be due to repetitive mechanical entrapment. Subsequent observational studies have led to the concepts of microinstability and glenohumeral internal rotatory deficit. Controversy remains regarding the exact pathophysiology, reflected in the variable outcomes in the treatment of these syndromes. The reporting radiologist must be aware of the constellation of image findings to alert the referring physician to the possibility of microinstability and internal impingement.

 
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