ABSTRACT
DIFFERENTIAL DIAGNOSIS Chronic Tendinitis (Impingement syndrome) Impingement syndrome is a condition that affects the rotator cuff causing shoulder pain. Impingement of the rotator cuff muscles against the coracoacromial ligament is believed to be the cause of this condition. Impingement occurs due to repetitive overhead activities such as swimming, skiing, tennis or jobs involving reaching overhead. Symptoms include pain and weakness. Pain originates in the shoulder and over the deltoid muscle and is exacerbated by overhead activities. A frequent complaint is night pain, often disturbing sleep, particularly when the patient lies on the affected shoulder. Weakness and loss of motion are associated symptoms. On examination the impingement tests described above are invariably positive. There is a painful arc between 60 and 120 degrees of abduction; however, it is usually resolved if the patient repeats abduction with the arm in full external rotation.
