In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .
Comparison of subacromial tenoxicam and steroid injections in the treatment of impingement syndrome.
OBJECTIVES This study aims to assess and compare the efficacy of subacromial tenoxicam and steroid injections in treating patients with shoulder impingement syndrome . PATIENTS AND METHODS Forty patients having shoulder impingement syndrome with findings of rotator cuff tendinitis or subacromial bursitis on magnetic resonance imaging were included in the study . Patients were r and omized into two subacromial injection groups : patients in the first group ( 10 males , 10 females ; mean age 45.3 years ; range 32 to 67 years ) were administered 20 mg tenoxicam three times by weekly intervals , and patients in the second group ( 8 males , 12 females ; mean age 46.5 years ; range 29 to 73 years ) were administered 40 mg methylprednisolone acetate just for once . Visual analog scale ( VAS ) , active range of motion ( ROM ) of the shoulder joint , and Disabilities of Arm , Shoulder and H and ( DASH ) question naire scores were evaluated at baseline , six weeks after treatment , and first year . RESULTS Visual analog scale , DASH , and active ROM scores in both groups were statistically significantly improved . No statistically significant difference was detected between subacromial tenoxicam and steroid injections in terms of post-treatment VAS , DASH , and active ROM scores . Mean pre- and post-treatment VAS scores in tenoxicam group were 7.8 ( range , 3 - 9 ) and 2.6 ( range , 2 - 4 ) , respectively . Mean pre- and post-treatment VAS scores in steroid group were 6.2 ( range , 3 - 10 ) and 3.6 ( range , 0 - 7 ) , respectively . Mean pre- and post-treatment DASH scores in tenoxicam group were 59.4 ( range , 45 - 80 ) and 14.7 ( range , 8.3 - 25.8 ) , respectively . Mean pre- and post-treatment DASH scores in steroid group were 56.7 ( range , 33.3 - 85.8 ) and 18.1 ( range , 0 - 69.2 ) , respectively . Although the improvement in active ROM was higher in the steroid group , difference between two groups was not statistically significant . CONCLUSION Both subacromial tenoxicam and steroid injections may be successfully used in the treatment of patients with impingement syndrome .  Subacromial tenoxicam injection may be preferred as a first-line intervention in these patients thanks to its safe profile
In many instances , no or minimal attempts to screen were undertaken or reported .
Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain .