What is a characteristic of Stage 2 in Neer's Classification for Primary Subacromial Impingement Syndrome?

• A. Insidious onset of pain
• B. Continued mechanical compression of RTC
• C. Thickening of fibrosis in the subacromial bursa
• D. Tearing of the biceps tendon

Answer: (C)

In Stage 2 of Neer's Classification for Primary Subacromial Impingement Syndrome, the characteristic feature is the thickening of fibrosis in the subacromial bursa. This stage represents a progression from the earlier stages, where there is initial inflammation due to repetitive mechanical irritation. The accumulation of fibrotic changes in the bursa indicates that the body is responding to the ongoing irritation and inflammation by developing scar tissue, which can further limit the movement and lead to pain.

The thickening of the subacromial bursa can contribute to the narrowing of the subacromial space, which may exacerbate symptoms as the mechanical function of the shoulder is compromised. This stage is critical because it signifies a shift from purely soft tissue irritability toward more significant physical changes in the bursa; proper management at this stage can be vital in preventing further deterioration.

The other options relate to different contexts; for instance, insidious onset typically reflects earlier stages or other injury processes, while continued mechanical compression would suggest later consequences that occur if the impingement is not addressed. Tearing of the biceps tendon generally indicates a more advanced condition beyond the Stage 2 classification.