Shoulder Impingement: Relationship of Clinical Symptoms and Imaging Criteria

Abstract

AHD seems to better reflect the clinical status of patients with subacromial impingement, but without rotator cuff tears, than acromial shape. Acromial shape is not a good descriptor of subacromial space narrowing.

What Imaging‐Detected Pathologies Are Associated With Shoulder Symptoms and Their Persistence? A Systematic Literature Review

“…In total, 56 articles were included (41 cross‐sectional, 11 cohort, 4 case–control). Imaging modalities included 25 ultrasound 16, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 24 MRI 15, 16, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 12 radiographs 27, 30, 49, 53, 55, 62, 65, 66, 67, 68, 69, 70, 3 bone scintigraphy 65, 71, 72, 2 PET 73, 74, and no computed tomography. Of these studies, 10 assessed associations with 2 imaging modalities (16, 27, 30, 41, …”

“…The mean (range) score was 48% 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67 for cohort, 41% 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41...…”

“…Twelve studies (23, 27, 34, 46, 47, 50, 53, 55, 56, 57, 62, 68) evaluated the relationship between the acromion and symptoms (Tables 1, 2, and 3). Two ultrasound studies 23, 34, 3 MRI studies 47, 50, 57, 1 radiographic study 68, 2 combined MRI and radiographic studies 53, 62 and 1 combined ultrasound and radiographic study 27 evaluated the relationship of the acromion and pain.…”

“…One study radiographically evaluated the relationship with function 68. Two MRI studies 46, 56 and 1 combined MRI and radiographic study 55 evaluated the relationship with symptoms using a composite score.…”

“…Two studies of mixed quality reported an association with acromial humeral distance (AHD) and symptoms 46, 55, but another high‐quality study found no association 56. One study showed no relationship with acromial shape 55, whereas another was positively correlated to the intrinsic acromial angle 46.…”