[Subacromial impingement. Evaluating the concept--diagnosis--therapeutic concepts].

Subacromial impingement is a condition that belongs to the group of diseases known collectively as periarthritis humeroscapularis and has a typical clinical presentation. The underlying cause is a late of sufficient space of various origin in the subacromial region that finally leads to rotator cuff damage. Depending on cause, three forms can be distinguished, primarily extrinsic, primarily intrinsic and secondary impingement. The diagnosis is primarily clinical (pain on raising the arms above the head, painful arc syndrome). The value of imaging techniques, and the diagnostic approach are described. Initially treatment is always conservative, but when pain becomes severe or function is lost, arthroscopic or open surgical treatment may be needed.