MRI showing subacromial<unk>  with partial rupture of the supraspinatus tendon, but no retraction or fatty degeneration of the supraspinatus muscle.<unk>  syndrome can be diagnosed by a targeted medical history and physical examination, but it has also been argued that at least medical imaging (generally X-ray initially) and/or response to local anesthetic injection is necessary for workup. On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test). These tests help localize the pathology to the rotator cuff; however, they are not specific for<unk> . Neer sign may also be seen with subacromial bursitis. Response to local anesthetic The physician may inject lidocaine (usually combined with a steroid) into the bursa, and if there is an improved range of motion and decrease in pain, this is considered a positive<unk>  Test". It not only supports the diagnosis for<unk>  syndrome, but it is also therapeutic. Imaging Plain x-rays of the<unk>  can be used to detect some joint pathology and variations in the bones, including acromioclavicular arthritis, variations in the acromion, and calcification. However, x-rays do not allow visualization of soft tissue and thus hold a low diagnostic value. Ultrasonography, arthrography and MRI can be used to detect rotator cuff muscle pathology. MRI is the best imaging test prior to arthroscopic surgery. Due to lack of understanding of the pathoaetiology, and lack of diagnostic accuracy in the assessment process by many physicians, several opinions are recommended before intervention.
Shoulder impingement syndrome
Rotator cuff tear
Facet syndrome
Snapping hip syndrome
Epicondylitis
Patellar subluxation syndrome
Patellofemoral pain syndrome
Milwaukee shoulder syndrome