Sonographic evaluation of subacromial space

Abstract

Goal of the study. The purpose of this study is to compare the accuracy of sonographic to radiographic measurements of subacromial space, and verify its variations in relation to acromial morphology, age, sex and rotator cuff pathologies. Materials and methods. As a result, we have compared a radiographic examination to sonographic examination, each measuring the subacromial space in 200 random shoulders, with a personal method. The sonographic examination was performed by using a HDI 5000 ultrasound scanner Sono-CT with 7.5 MHz linear array transducer. No stand-off pad was utilized. Results. The statistical analysis of the data derived from the two measurements was not sufficient to conclude that the two techniques are different (p > 0:8). They also correspond with the radiographic morphology of the acromion. The size of subacromial space was related to the acromial morphology, female gender, and rotator cuff pathology, however, it was not related to age. Discussion and conclusions. Our results clearly show that sonographic measurements are very close to those obtained by X-ray (p > 0:8). The Bland-Altman analysis showed that for all groups, the were small enough to give us confidence that the sonographic technique may be used in place of the radiographic one for clinical purposes. One-way ANOVA showed that sonographic measurements were statistically different among the four groups (p < 0:05). The sonography demonstrated precision, accuracy and carefulness in the measurement of the subacromial space.

In vivo measurement of subacromial space width during shoulder elevation: Technique and preliminary results in patients following unilateral rotator cuff repair

“…These previous studies have measured the subacromial space under in-vivo conditions with various imaging modalities, including three-dimensional (3D) computed tomography (Lochmuller et al, 1997), clinical radiographs (van de Sande and Rozing, 2006,van de Sande et al, 2006,Lehtinen et al, 2000,Petersson and Redlund-Johnell, 1984, ultrasound imaging (Girometti et al, 2006,Azzoni et al, 2004, and MRI (Pappas et al, 2006,Graichen et al, 1998,Graichen et al, 1999b,Graichen et al, 1999a,Graichen et al, 2001,Graichen et al, 2005,Hinterwimmer et al, 2003,Roberts et al, 2002,Solem-Bertoft et al, 1993. Additional studies have estimated the subacromial space width based on shoulder kinematics as measured using skin-mounted sensors (Tsai et al, 2003,Thigpen et al, 2006,Ludewig and Cook, 2002,Nawoczenski et al, 2003.…”

Effect of Posture on Acromiohumeral Distance With Arm Elevation in Subjects With and Without Rotator Cuff Disease Using Ultrasonography

“…1,15,19 Studies using ultrasound imaging corroborate these findings with a smaller AHD in patients with RCD 3,14 and a smaller AHD with increased severity of the RCD. 3 Although these studies consistently indicated a smaller AHD with RCD, they varied on the location of the measurement of the SAS. MRI studies 1,15,19 depicted the location as the anterior to middle aspect of the SAS, or at the location of the small- used as described in this study, using the same investigator to collect data and make AHD measurements.…”

“…Studies using ultrasound imaged the SAS over the middle SAS space, 2,3 or did not state the exact location of the ultrasound transducer during imaging.…”

“…1,3,14,15,19 Studies using MRI reported a smaller AHD in patients with impingement syndrome as compared to healthy shoulders. 1,15,19 Studies using ultrasound imaging corroborate these findings with a smaller AHD in patients with RCD 3,14 and a smaller AHD with increased severity of the RCD.…”

Acromial Morphology and Subacromial Architecture in a South African Population

“…Azzoni et al (2004) stated that the severity of rotator cuff pathologies is directly proportional to the decreasing magnitude of the subacromial space. The rhomboidal and triangular subacromial spaces as reported by Sperner (1995) were identified in this study.…”