Digital dynamic radiography—a novel diagnostic technique for posterior shoulder instability: a case report

Serratus anterior palsy as a Masquerader: utilizing novel digital dynamic radiography for diagnosis and treatment response

“… 33 DDR can be implemented into clinical workflow to diagnose scapular pathologies, such as SA palsy, by objectively measuring parameters such as SHR to improve diagnosis and treatment of scapular winging. 14 , 23 …”

“…Current literature has already examined dynamic radiography to diagnose shoulder pathologies such as adhesive capsulitis, glenohumeral osteoarthritis, rotator cuff tears, and posterior shoulder instability. 14 , 33 Xiao et al used DDR to suggest that the SHR of normal shoulders may actually be closer to 3.5 for complete shoulder motion. 33 However, this was using the medial scapula border for measurement analysis which is thought to overestimate the SHR.…”

“…Of note, SHR is typically calculated across the full arc of motion and at standard intervals of 0-30, 30-60, and 60-90. 14 Due to this patient’s limited preoperative ROM from 45° to 90° of humeral abduction ( Fig. 1 A and B ), we calculated SHR (total arc) to be 7.8.…”

“…To overcome these challenges, Dynamic Digital Radiography (DDR) has emerged as a promising tool for in-office imaging of dynamic shoulder pathologies such as rotator cuff tears, anterior and posterior shoulder instability, and adhesive capsulitis. 14 , 33 DDR allows for an objective measurement of SHR - the ratio between the change in humeral motion and the change in scapula motion during arm abduction, using standardized positioning and protocol. 14 , 33 DDR empowers the surgeon to make an in-office diagnosis to more appropriately guide further work-up or surgical interventions, and aids with patient communication, education, and compliance with therapy.…”

“… 14 , 33 DDR allows for an objective measurement of SHR - the ratio between the change in humeral motion and the change in scapula motion during arm abduction, using standardized positioning and protocol. 14 , 33 DDR empowers the surgeon to make an in-office diagnosis to more appropriately guide further work-up or surgical interventions, and aids with patient communication, education, and compliance with therapy. Furthermore, DDR can be used to evaluate response to treatment.…”