JOINT IMPINGEMENT SYNDROME - CLINICAL-FEATURES

Joint impingement is a painful syndrome caused by the friction of join t tissues, which is both the cause and the effect of altered joint bio mechanics. From the anatomical and clinical viewpoints, these syndrome s are classified as bone impingement, soft tissue impingement and entr apment neuropathy, depending on what joint portion impinges on the oth ers. We considered the most important impingement syndromes of the upp er and the lower limbs from the clinical viewpoint. As for the upper l imb, supraspinatus impingement is a frequent cause of shoulder pain in both athletes and the normal population; the painful subacromial arch is a typical sign of the rotator cuff impingement syndrome and of out let and non-outlet impingement as well. As for the elbow, we considere d both medial and lateral impingement. The carpal tunnel syndrome is t he most common peripheral entrapment neuropathy of the upper limb; it is caused by compression of the median nerve at the wrist. We consider ed the main causes of carpal tunnel narrowing and the relative clinica l findings. As for the lower limb, we considered the iliotibial band f riction syndrome, which is the most common overuse syndrome of the kne e and the ankle impingement syndrome. The latter includes anterolatera l impingement (with chronic anterolateral and lateral pain and ankle i nstability), sinus tarsi impingement, anterior impingement (with pain during foot dorsiflection and posterior impingement. The tarsal tunnel syndrome is the most important ankle entrapment neuropathy causing bu rn pain and paresthesias in the toes and sole of the foot. (C) 1998 El sevier Science Ireland Ltd. All rights reserved.