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Case Reports in Orthopedics
Volume 2014 (2014), Article ID 760219, 3 pages
http://dx.doi.org/10.1155/2014/760219
Case Report

Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

Division of Orthopaedic Surgery, CHU de Québec—Enfant-Jésus Hospital, 1401 18th Street, Québec, QC, Canada G1J 1Z4

Received 14 December 2013; Accepted 18 January 2014; Published 23 February 2014

Academic Editors: M. Massobrio and D. Saragaglia

Copyright © 2014 Jean-Christophe Murray and Stéphane Pelet. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.