MRI of impingement syndromes of the shoulder

Mulyadi, Ellie; Harish, Srinivasan; O’Neill, John D.; Rebello, Ryan

doi:10.1016/j.crad.2008.08.013

Cited by 29 publications

(19 citation statements)

References 49 publications

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“…Physical examination and conventional radiographic modalities are sensitive but not very specific, so a diagnosis based on these examination results alone is not always accurate [24-26]. MRI is a reliable technique to evaluate shoulder abnormalities, but it provides only static and indirect evaluation of the shoulder [27-29]. In contrast, musculoskeletal sonography can characterize a spectrum of abnormalities of impingement syndrome by providing real-time, dynamic, and reliable information [30-35].…”

Section: Introductionmentioning

confidence: 99%

Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion - dynamic sonographic evaluation

et al. 2014

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BackgroundClavicular hook plates are effective fixation devices for distal clavicle fractures and severe acromioclavicular joint dislocations. However, increasing number of studies has revealed that subacromial portion of the hook may induce acromial bony erosion, shoulder impingement, or even rotator cuff damage. By sonographic evaluation, we thus intended to determine whether the presence of hook plate may induce subacromial shoulder impingement and its relationship relative to surrounding subacromial structures.MethodsWe prospectively followed 40 patients with either distal clavicle fracture or acromioclavicular joint dislocation that had surgery using the Arbeitsgemeinschaft für Osteosynthesefragen (AO) clavicular hook plate. All patients were evaluated by monthly clinical and radiographic examinations. Static and dynamic musculoskeletal sonography examinations were performed at final follow-up before implant removal. Clinical results for pain, shoulder function, and range of motion were evaluated using Constant-Murley and Disability of Arm, Shoulder, and Hand (DASH) scores.ResultsClinically, 15 out of 40 patients (37.5%) presented with subacromial impingement syndrome and their functional scores were poorer than the non-impinged patients. Among them, six patients were noted to have rotator cuff lesion. Acromial erosion caused by hook pressure developed in 20 patients (50%).ConclusionsWe demonstrated by musculoskeletal sonography that clavicular hook plate caused subacromial shoulder impingement and rotator cuff lesion. The data also suggest an association between hardware-induced impingement and poorer functional scores. To our knowledge, the only solution is removal of the implant after bony consolidation/ligamentous healing has taken place. Thus, we advocate the removal of the implant as soon as bony union and/or ligamentous healing is achieved.

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Section: Introductionmentioning

confidence: 99%

Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion - dynamic sonographic evaluation

et al. 2014

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“…If the partially torn tendon was swollen with signal void on every pulse sequence and calcific lesions on plain radiography, calcific tendinitis was diagnosed. The main MRI finding of subdeltoid bursitis was fluid collection between the deltoid muscle and supraspinatus tendon greater than 3 mm in thickness (13). If no signal change or disruption of the tendon fiber was visible in the tendon and no fluid collection was observed around the tendon, then the MRI diagnosis was no tendon tear or tendinitis.…”

Section: Case Selectionmentioning

confidence: 99%

Association Between Subacromial Impingement and Acromiohumeral Distance on MRI

et al. 2018

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Background: We use MRI to determine the mean acromiohumeral distance (AHD) in subacromial impingement (SI) and to identify which part of the subacromial space has the strongest effect on impingement. Objectives: To assess the association between AHD and SI and to determine which subacromial site most strongly correlates with impingement. Patients and Methods:The patient population was composed of 56 (70%) men and 24 (30%) women; 45 patients had SI and 35 did not. We measured the shortest distance from the outer margin of the inferior cortex of the acromion to the upper cortex of the humeral head at a total of six points. The mean AHD at each location was compared between patients with and without SI using Mann-Whitney tests. To define the optimal cutoff value at each location for the diagnosis of SI, we applied a receiver operating characteristic (ROC) curve and maximum Youden index. Results: Mean AHDs in patients with SI were smaller than those of normal patients. Differences in the length of the lateral and central portions were statistically significant (P < 0.05). A 7.9-mm cutoff value at the lateral anterior portion showed 96% sensitivity and 43% specificity for SI. Cutoff values of 7.8 mm (reader 1, senior radiologist) and 7.5 mm (reader 2, junior radiologist) at the lateral posterior portion showed 89% and 78% sensitivity and 46% and 57% specificity, respectively. Conclusion: Patients with SI had narrower AHDs than patients without impingement, and specifically, the lateral and central portions of the acromion played an important role in the development of SI.

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“…supraspinatus repair 6 , signs of this condition on preoperative MRI may be the necessary clue in leading to a thorough arthroscopic examination of the subscapularis-coracoid relationship, which may ultimately lead to the decision to perform a subcoracoid decompression 35 . Friedman et al 27 assessed the CHI in 50 asymptomatic volunteers and 75 patients with symptomatic shoulders, all of whom underwent a cine MRI of the shoulder using a shoulder-rotating device.…”

Section: Subcoracoid Impingement and Subscapularis Tendon: Is There Amentioning

confidence: 99%

Subcoracoid impingement and subscapularis tendon: is there any truth?

Osti

Soldati

Buono

et al. 2013

MLTJ

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SummarySubcoracoid impingement and stenosis have been described related to anterior shoulder pain and subscapularis tendon tears, but the pathogenesis and related treatment of this condition has still not been explained properly. Variability of coracoid morphology has been described and both traumatic and iatrogenic factors can modify it. Some authors referred this to a primary narrow coracohumeral distance with different threshold values defined as increased risk factor for subscapularis and antero-superior RC tear; opposite theories stated that the stenosis is secondary to an anterosuperior translation of the humeral head toward the coracoid due to degenerative changes of the rotator cuff tendons. Limited coracoplasty can be performed when related risk factors are identified; however no clear consensus arises from specific literature review and extensive clinical and instrumental examination of the patient should be performed in order to identify specific risk factors for subscapularis tendon pathology and, subsequently, tailor the proper approach.

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MRI of impingement syndromes of the shoulder

Cited by 29 publications

References 49 publications

Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion - dynamic sonographic evaluation

Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion - dynamic sonographic evaluation

Association Between Subacromial Impingement and Acromiohumeral Distance on MRI

Subcoracoid impingement and subscapularis tendon: is there any truth?

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