Radiological Variabilities in Subcoracoid Impingement: Coracoid Morphology, Coracohumeral Distance, Coracoglenoid Angle, and Coracohumeral Angle

Abstract

BackgroundThe aim of this study was to investigate the effects of coracoid morphology, coracohumeral distance, coracoglenoid angle, and coracohumeral angle variabilities on subcoracoid impingement development using magnetic resonance imaging (MRI).Material/MethodsA total of 200 patients (87 males with mean age of 51.1±15.2 years and 113 females with mean age of 52.6±10.7 years) undergoing shoulder MRI were included in this retrospective study. All MRI studies were performed with standard positioning. Coracoid morphology and subscapularis tendon were evaluated. Coracohumeral distance, coracoglenoid angle and coracohumeral angle were measured in all subjects. One-way ANOVA was used to assess the difference between the groups. For binary comparisons, Tukey post hoc analysis was done. Pearson correlation analysis was performed between variables.ResultsType C coracoid was more frequent in the tendinosis and tendon tear groups. There was a significant difference between type C coracoid and the other coracoid types for coracohumeral distance values (P=0.016). There was a statistically significant decrease in coracoglenoid angle values and coracohumeral distance in patients with subscapularis tendon pathologies (P=0.000). A statistically insignificant increase in coracohumeral angle values was found in the subscapularis tendon pathologies. There was a positive correlation between coracohumeral distance and coracoglenoid angle (R=0.749 P=0.000). There was a negative correlation between coracohumeral distance and coracohumeral angle (R=−0.668 P=0.000) and between coracoglenoid angle and coracohumeral angle (R=−0.605 P=0.000).ConclusionsIn subscapularis tendon pathologies, decrease in coracohumeral distance and coracoglenoid angle was observed. A new approach uses coracohumeral angle to evaluate subcoracoid impingement. A statistically insignificant increase in coracohumeral angle was noted.

Less than 9.5-mm coracohumeral distance on axial magnetic resonance imaging scans predicts for subscapularis tear

“…Recently, there have been attempts to find more robust correlations between SSC lesions and the coracoid morphology by using multiple quantifiable parameters such as coracoid index and coracoglenoid inclination, 26 coracoid overlap, 4 , 12 coracoid base angel, 4 , 24 coracohumeral angle, 1 and even measurements of angle and distance in a sagittal plane. 20 , 24 Some of these parameters exhibit the advantage of being uninfluenced by arm rotation, but well-accepted cutoff values are still missing and no consensus exists, which parameters are most reliable.…”

MRI evaluation of coracoid morphology, coracohumeral distance, coracoglenoid angle and coracohumeral angle in subcoracoid impingement

“…Subkorakoid sıkışma sendromu, anterior omuz ağrısının nedeni olup ilk olarak Gerber ve ark. tarafından tanımlanmıştır (6). Subkorakoid sıkışmada idiyopatik, iatrojenik, anatomik ve travmatik faktörler etyolojide rol oynar (5).…”

“…Literatürde yapılan bir çalışmada korakoid tiplerinden en sık tip A; normal tendon grubunda ise en az Tip C korakoidin izlendiğini; tip C korakoidin, subskapular tendon patolojileri olan grupta daha sık görüldüğü bildirilmiştir (6). Sunulan çalışmada, en sık görülen korakoid tipi Tip A, en az görülen Tip C idi.…”

“…ları (6) subskapularis tendon yırtıklarında korakohumeral mesafenin daraldığını göstermişler ve ortalama değeri 6 mm olarak bulmuşlardır. Tendinoz ve yırtık grupları arasında korakohumeral mesafe değerlerinde istatistiksel olarak anlamlı farklılık saptamamışlar (6). Sunulan çalışmada korakohumeral mesafe tendon yırtığı olan grupta daralmış olup ortalama değeri 5.40 mm bulundu.…”

Korakoid morfolojisi ve korakohumeral mesafenin değerlendirilmesi

“…Yazarlar, erkek ve kadın örnekler arasında hem subkorakoid mesafeleri hemde korakoid morfolojinin benzer olduğunu ifade etmişlerdir. Asal ve Şahan'ın 23…”