Evaluation of the cross-sectional area of acromion process for shoulder impingement syndrome
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Background: Anatomic changes in the acromion have been considered a main cause of shoulder impingement syndrome (SIS). To evaluate the relationship between SIS and the acromion process, we devised a new morphological parameter called the acromion process cross-sectional area (APA). We hypothesized that the APA could be an important morphologic diagnostic parameter in SIS. Methods: We collected APA data from 95 patients with SIS and 126 control subjects who underwent shoulder magnetic resonance imaging (MRI). Then we measured the maximal cross-sectional area of the bone margin of the acromion process on MRI scans. Results: The mean of APAs were 136.50 ± 21.75 mm2 in the male control group and 202.91 ± 31.78 mm2 in the male SIS group; SIS patients had significantly greater APAs (P < 0.001). The average of APAs were 105.38 ± 19.07 mm2 in the female control group and 147.62 ± 22.90 mm2 in the female SIS group, and the SIS patients had significantly greater APAs (P < 0.001). The optimal APA cut-off in the male group was 165.14 mm2 with 90.2% sensitivity, 91.4% specificity, and an area under the curve (AUC) of 0.968. In the female group, the optimal cut-off was 122.50 mm2 with 85.2% sensitivity, 84.9% specificity, and an AUC of 0.928. Conclusions: The newly devised APA is a sensitive parameter for assessing SIS; greater APA is associated with a higher possibility of SIS. We think that this result will be helpful for the diagnosis of SIS.
Abstract
Background: Anatomic changes in the acromion have been considered a main cause of shoulder impingement syndrome (SIS). To evaluate the relationship between SIS and the acromion process, we devised a new morphological parameter called the acromion process cross-sectional area (APA). We hypothesized that the APA could be an important morphologic diagnostic parameter in SIS. Methods: We collected APA data from 95 patients with SIS and 126 control subjects who underwent shoulder magnetic resonance imaging (MRI). Then we measured the maximal cross-sectional area of the bone margin of the acromion process on MRI scans. Results: The mean of APAs were 136.50 ± 21.75 mm2 in the male control group and 202.91 ± 31.78 mm2 in the male SIS group; SIS patients had significantly greater APAs (P < 0.001). The average of APAs were 105.38 ± 19.07 mm2 in the female control group and 147.62 ± 22.90 mm2 in the female SIS group, and the SIS patients had significantly greater APAs (P < 0.001). The optimal APA cut-off in the male group was 165.14 mm2 with 90.2% sensitivity, 91.4% specificity, and an area under the curve (AUC) of 0.968. In the female group, the optimal cut-off was 122.50 mm2 with 85.2% sensitivity, 84.9% specificity, and an AUC of 0.928. Conclusions: The newly devised APA is a sensitive parameter for assessing SIS; greater APA is associated with a higher possibility of SIS. We think that this result will be helpful for the diagnosis of SIS.
참고문헌 (23)
- Roidis NT, "The influence of the acromioclavicular joint degeneration on supraspinatus outlet impingement and the acromion shape", J Orthop Surg(Hong Kong), 17, pp.331~334 (2009)
- Aydin A, "The role of acromion morphology in chronic subacromial impingement syndrome", Acta Orthop Belg, 77, pp.733~736 (2011)
- Balke M, "Acromial morphology in patients with calcific tendinitis of the shoulder", Knee Surg Sports Traumatol Arthrosc, 22, pp.415~421 (2014)
- 신근만, "Partial-Thickness Rotator Cuff Tears", The Korean Journal of Pain, 24(2), pp.69~73 (2011), 대한통증학회
- Hughes PC, "Measurement of subacromial impingement of the rotator cuff", J Sci Med Sport, 15, pp.2~7 (2012)
- Seeger LL, "Shoulder impingement syndrome : MR findings in 53 shoulders", AJR Am J Roentgenol, 150, pp.343~347 (1988)
- Balke M, "Correlation of acromial morphology with impingement syndrome and rotator cuff tears", Acta Orthop, 84, pp.178~183 (2013)
- Natsis K, "Correlation between the four types of acromion and the existence of enthesophytes : a study on 423 dried scapulas and review of the literature", Clin Anat, 20, pp.267~272 (2007)
- Saha S, "Morphometric evaluation of adult acromion process in North Indian population", J Clin Diagn Res, 11, pp.AC08~11 (2017)
- Kanatli U, "The role of radiological subacromial distance measurements in the subacromial impingement syndrome", Eur J Orthop Surg Traumatol, 23, pp.317~322 (2013)
- Li X, "Relationship between acromial morphological variation and subacromial impingement : a three-dimensional analysis", PLoS One, 12, pp.e0176193~ (2017)
- Yamaguchi K, "The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders", J Bone Joint Surg Am, 88, pp.1699~1704 (2006)
- Edelson JG, "Bony anatomy of coracoacromial arch : implications for arthroscopic portal placement in the shoulder", Arthroscopy, 9, pp.201~208 (1993)
- Zuckerman JD, "The influence of coracoacromial arch anatomy on rotator cuff tears", J Shoulder Elbow Surg, 1, pp.4~14 (1992)
- Mansur DI, "Morphometry of acromion process of human scapulae and its clinical importance amongst Nepalese population", Kathmandu Univ Med J (KUMJ), 10, pp.33~36 (2012)
- Gagey N, "Anatomy of the acromial arch : correlation of anatomy and magnetic resonance imaging", Surg Radiol Anat, 15, pp.63~70 (1993)
- Kitay GS, "Roentgenographic assessment of acromial morphologic condition in rotator cuff impingement syndrome", J Shoulder Elbow Surg, 4, pp.441~448 (1995)
- Banas MP, "Relationship between the lateral acromion angle and rotator cuff disease", J Shoulder Elbow Surg, 4, pp.454~461 (1995)
- Nyffeler RW, "Association of a large lateral extension of the acromion with rotator cuff tears", J Bone Joint Surg Am, 88, pp.800~805 (2006)
- Mayerhoefer ME, "Shoulder impingement : relationship of clinical symptoms and imaging criteria", Clin J Sport Med, 19, pp.83~89 (2009)
- Takase K, "Histological and ultrastructural changes in the undersurface of the acromion with subacromial impingement", Acta Orthop, 76, pp.386~391 (2005)
- McGinley JC, "Rotator cuff tears : association with acromion angulation on MRI", Clin Imaging, 36, pp.791~796 (2012)
- Michener LA, "Supraspinatus tendon and subacromial space parameters measured on ultrasonographic imaging in subacromial impingement syndrome", Knee Surg Sports Traumatol Arthrosc, 23, pp.363~369 (2015)