Publication:

Diagnostic pitfalls in shoulder impingement syndrome in overhead athletes: a narrative review

Shoulder impingement syndrome is a frequently assigned diagnosis in overhead athletes presenting with shoulder pain, yet it often serves as a nonspecific label rather than a precise explanation of symptoms. In this population, impingement complaints are more commonly secondary to altered glenohumeral mechanics, scapular dyskinesis, instability, or kinetic chain dysfunction rather than primary structural narrowing of the subacromial space. As a result, misdiagnosis is common and may lead to prolonged symptoms, ineffective rehabilitation, or unsuccessful surgical intervention. This narrative review examines common diagnostic pitfalls encountered in the evaluation of shoulder impingement syndrome in overhead athletes, discusses the limitations of imaging, and emphasizes the importance of sport-specific clinical assessment. A structured diagnostic algorithm is proposed to improve diagnostic accuracy and guide management in this challenging patient population.