Shoulder Impingement or Costovertebral Dysfunction?

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Tejinder Singh, Dr. Parijat Kumar

Abstract

A cluster usually diagnoses the subacromial impingement of tests, including Neer's impingement test, Hawkins Kennedy test, empty can, and resisted lateral rotation test. The tests have higher sensitivity and specificity but do not account for altered rib mechanics as the cause of the impingement. The primary cause of impingement in the clusters of tests is altered integrity of glenohumeral mechanics due to possible injury to rotator cuff muscle. There is very little literature on altered costovertebral mechanics causing subacromial impingement. This article highlights the importance of third and fourth costovertebral biomechanics in patients with shoulder impingement.

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