Value of radiographic measurements in depiction of glenohumeral and acromial anatomical changes in patients with subacromial impingement syndrome and rotator cuff tears
https://doi.org/10.24835/1607-0763-2018-3-98-108
Abstract
The purpose. Optimization of radiographic study of the shoulder in patients with SIS and estimation of the clinical value of radiographic measurements in SIS diagnosis and rotator cuff tears (RCT).
Materials and methods. 128 patients with a painful shoulder (67 women, 61 men), mean age 57.3 ± 12.8 y.o. and 35 patients without shoulder pain mean age 56 ± 10.4 y.o. underwent a complex study including radiography, MRI, MDCTor MR-arthrography, arthroscopy. Special angles and distances were estimated on a Radiographic Work Station by 2 radiologists (acromion tilt (AT), acromion slope, inferior acromion protrusion, acromio-humeral distance, acromio-humeral index, critical shoulder angle (CSA), lateral acromion angle, transverse acromion angle). Mean values of these parameters were compared between patients with SIS and control group, and between patients with RCT and without . Test-retest reproducibility and inter rater agreement were calculated with Kohen’s kappa. Diagnostic value of the most informative parameters was compared with estimation of AUC under the ROC curve.
Results. CSA and AT demonstrated independence with age and excellent test-retest reproducibility. In SIS patients mean values of CSA were statistically higher (35.78 ± 4.64°), AT values – lower (25.90 ± 4.27°), then in controls. In all patients with CSA more then 35, the frequency of RCT was 74%. In patients with RCT were detected higher values of CSA (36.70 ± 2.61°) and lower values of AT (23.67 ± 3.07°), then in patients without tears. Lateral acromion angle (acromion type) demonstrated correlation with patient’s age and moderate reproducibility in test-retest studies.
Conclusion. AT (measured on the outlet X-ray view) and CSA (measured in direct views) could be recommended for clinical use for evaluation of patients with SIS and prognosing RCT.
About the Authors
V. E. Gazhonova
Federal Budget Organization “United hospital and policlinic” Administrative Directorate of the President of the Russian Federation;
Postgraduate professional education “Central State Medical Academy” Administrative Directorate of the President of the Russian Federation
Russian Federation
Russian Federation
Veronika E. Gazhonova – doct. of med. sci., professor, professor of radiology department of postgraduate professional education “Central State Medical Academy” management department of the president of Russian Federation; head of US-angiography of “United hospital and policlinic” Administrative Directorate of the President of the Russian Federation
121359, Moscow, Marshala Timoshenko str., 19а
Е. M. Bachurina
Postgraduate professional education “Central State Medical Academy” Administrative Directorate of the President of the Russian Federation
Russian Federation
Russian Federation
Elena M. Bachurina – head of radiology department
Moscow
M. V. Emelianenko
Postgraduate professional education “Central State Medical Academy” Administrative Directorate of the President of the Russian Federation
Russian Federation
Russian Federation
Mikhail V. Emelianenko – orthopedic traumatologist of the surgery department
Moscow
I. E. Popova
Postgraduate professional education “Central State Medical Academy” Administrative Directorate of the President of the Russian Federation
Russian Federation
Russian Federation
Irina E. Popova – radiologist of radiology department
Moscow
T. A. Soina
Postgraduate professional education “Central State Medical Academy” Administrative Directorate of the President of the Russian Federation
Russian Federation
Russian Federation
Tatyana A. Soina – radiologist of radiology department
Moscow
I. M. Kurnosova
Postgraduate professional education “Central State Medical Academy” Administrative Directorate of the President of the Russian Federation
Russian Federation
Russian Federation
Irina D. Kurnosova – resident of radiology department
Moscow
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Review
For citations:
Gazhonova V.E., Bachurina Е.M., Emelianenko M.V., Popova I.E., Soina T.A., Kurnosova I.M. Value of radiographic measurements in depiction of glenohumeral and acromial anatomical changes in patients with subacromial impingement syndrome and rotator cuff tears. Medical Visualization. 2018;(3):98-108. (In Russ.) https://doi.org/10.24835/1607-0763-2018-3-98-108
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