The Internal Impingement Sign is used to indicate which condition?

• A. Impingement test
• B. Rotator cuff tear
• C. Adhesive capsulitis
• D. Posterior impingement

Answer: (A)

The key idea here is recognizing impingement within the shoulder joint through a provocative sign. The internal impingement sign is used to identify impingement syndrome, specifically the type that affects the posterior-superior structures when the arm is placed in positions like 90 degrees of abduction with external rotation. Reproducing pain in this position points to impingement of the rotator cuff tendons and related tissue between the humeral head and the glenoid rim, rather than a primary frozen shoulder or a standalone rotator cuff tear.

Adhesive capsulitis (frozen shoulder) typically presents with global, non-specific loss of range of motion and capsular stiffness, not a focal impingement pain reproduced by this maneuver. While rotator cuff pathology can accompany impingement, the sign is specifically used to indicate impingement rather than diagnosing a tear alone. Posterior impingement is a subtype seen in throwers, but the maneuver is described as an impingement test in general, capturing the presence of impingement rather than labeling a distinct posterior impingement diagnosis.