چکیده (انگلیسی):

Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space
and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromioclavicular
joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires
left from previous surgery can cause similar symptoms. We present a series of four cases mimicking
“classical” impingement symptoms/signs in which the causal pathology was identified outside the subacromial
space. Magnetic Resonance Imaging (MRI) showed lesions that were present in the supraspinatus
fossa but were causing pressure effects on the sub-acromial space, namely - a ganglion cyst
in one case, lipomata in two other cases, and a glomus tumour. A ganglion cyst and glomus tumour
mimicking impingement syndrome is a rare reported case to our knowledge.
These are unusual causes that should be considered when investigating classical impingement syndrome
and particularly those who may have failed to respond to decompression surgery. They highlight
the potential value of looking beyond the sub-acromial space for causal lesions and in these cases, at a
time when limited ultrasound investigation has become increasingly popular; MRI has clearly played an
important and was essential in planning surgery as these lesions would not have been identified on USS.
Even though the symptoms were classical