What does Stage 3 of Primary Subacromial Impingement Syndrome typically involve?

• A. Mechanical irritation without tears
• B. Thickening of the rotator cuff
• C. RTC tears and lesions of the biceps tendon
• D. Only associated pain without structural damage

Answer: (C)

Stage 3 of Primary Subacromial Impingement Syndrome characterizes a progression in the condition where there is a significant structural change in the shoulder. This stage commonly involves full-thickness rotator cuff tears and potential lesions of the biceps tendon.

As the condition progresses from earlier stages, the mechanical irritation previously experienced can lead to more severe damage, necessitating a further examination of the soft tissue structures in the shoulder. The presence of rotator cuff tears indicates that the tendon has been compromised, often due to chronic wear and repetitive overhead activities that exacerbate the situation. Lesions of the biceps tendon may occur concurrently due to the close anatomic relationship and mechanical stress within the shoulder complex. This aligns with findings in the clinical literature that stage 3 represents a more advanced deterioration of the structural integrity of the shoulder.

The other stages involve different pathological changes, such as inflammation and mechanical irritation without tearing or significant tissue damage in the earlier stages. Stage 3 distinctly stands out because of the tangible structural damage it represents, particularly with the presence of tears, thereby confirming the chosen answer as the accurate representation of this disease stage.