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Background One possible cause of shoulder pain is rotator cuff contact with the superior glenoid (cuff-glenoid contact) with the arm in flexion, as occurs during a Neer impingement sign. It has been assumed that the pain with a Neer impingement sign on physical examination of the shoulder was secondary to the rotator cuff making contact with the anterior and lateral acromion. Questions/purposes We determined if the arm position where pain occurs with a Neer impingement sign would correlate with the position where the rotator cuff made contact with the superior glenoid, as determined by arthroscopic evaluation. Patients and Methods We prospectively studied 398 consecutive patients with a positive Neer impingement sign during office examination and used a handheld goniometer to measure (in degrees of flexion) the arm position in which impingement pain occurred. During subsequent arthroscopy, the arm was moved into a similar position, and we measured the arm's position in flexion at the point the rotator cuff made contact with the superior glenoid using a handheld goniometer. We compared the degrees of flexion at which pain occurred preoperatively and at which there was cuff-glenoid contact.

A 52-year-old woman underwent vertebroplasty for fractures of the T10, T11, and L2 vertebrae secondary to multiple myeloma. She was discharged uneventfully within a week. Nine months later, she was readmitted for syncope. Echocardiography revealed a mass in the right atrium. Magnetic resonance imaging (MRI) revealed a low signal intensity irregular mass (8x7 mm) and a comma-shaped mass (12 mm) in the right atrium. She was prophylactically anticoagulated for the probable emboli. Repeat cardiac MRI performed 2 weeks later showed that the size of the masses remained unchanged. Surgical intervention was not suggested by the cardiothoracic surgeons. Three months later, the patient remained uneventful.

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