The accuracy of plain radiographs in diagnosing degenerate rotator cuff disease

Chin, Kuen Yeow; Chowdhury, Alex; Leivadiotou, Dimitra; Marmery, Helen; Ahrens, Philip

doi:10.1177/1758573217743942

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…In this study, the subcoracoid cyst was measured in the axial plane. Mostly, the greater tubercle cysts were considered to be associated with supraspinatus tendon tears [ 34 , 35 ], clinicians speculated that the lesser tuberosity cysts (LTC) maybe be related to SSC tendon tears [ 27 , 32 ]. We evaluated the presence of lesser tuberosity cysts and measured their maximum diameter in the fat-suppressed T2-weighted axial plane.…”

Section: Methodsmentioning

confidence: 99%

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Wang

Xue

2022

BMC Musculoskelet Disord

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Background There are still some challenges in diagnosing subscapularis (SSC) tendon tears as accurately as posterosuperior rotator cuff tears on MRI. The omission of SSC tendon tear can lead to muscle atrophy, fatty infiltration, and increased tearing accompanied by aggravated shoulder pain and loss of function. An effective non-invasive evaluation tool will be beneficial to early identification and intervention. The study aims to identify sensitive predictors associated with SSC tendon tears and develop a risk prediction model to assist in diagnosis. Methods Data on 660 patients who received shoulder arthroscopic surgery with preoperative shoulder MRI were collected retrospectively. Of these, patients with SSC tendon tears were defined as the SSC tear group, and patients with intact SSC tendon were enrolled in the non-SSC tear group. Logistic regression analysis was used to identify the key predictors of SSC tendon tears which were then incorporated into the nomogram. Results Among 22 candidate factors, five independent factors including coracohumeral distance (CHD, oblique sagittal plane) (OR, 0.75; 95%CI, [0.67–0.84]), fluid accumulation (Y-face) (OR, 2.29; 95%CI, [1.20–4.38]), long head of biceps tendon (LHB) dislocation/subluxation (OR, 3.62; 95%CI, [1.96–6.68]), number of posterosuperior (PS) rotator cuff tears (OR, 5.36; 95%CI, [3.12–9.22]), and MRI diagnosis (based on direct signs) (OR, 1.88; 95%CI, [1.06–3.32]) were identified as key predictors associated with SSC tendon tears. Incorporating these predictors, the nomogram achieved a good C index with a good agreement on the risk estimation of calibration plots. Higher total points of the nomogram were associated with a greater risk of SSC tendon tears. Conclusion When evaluating the severity of SSC tendon injury, the combination of reliable predictors can improve the sensitivity and diagnostic performance of MRI. This model provides an individualized probability of risk prediction, which is convenient for clinicians to identify patients at high risk for SSC tendon tears to avoid missed diagnosis.

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Section: Methodsmentioning

confidence: 99%

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Wang

Xue

2022

BMC Musculoskelet Disord

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“…The acromiohumeral distance (AHD) is defined as the shortest distance between the inferior cortex of the acromion and the top of the humeral head on a true anteriorposterior (AP) radiograph (Grashey view). Superior migration of the humeral head resulting in a smaller AHD is associated with the presence of rotator cuff tears (RCT) [1, 3, 20, 22]. Recently, the AHD has been established as an outcome parameter for superior capsule reconstruction [13, 17].…”

Section: Introductionmentioning

confidence: 99%

The acromiohumeral distance in the MRI should not be used as a decision criterion to assess subacromial space width in shoulders with an intact rotator cuff

Hufeland

Brusis

Kubo

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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PurposeThe acromiohumeral distance is in practice often evaluated on MRI by radiologists and a reduction diagnosed as subacromial impingement. However, the acromiohumeral distance as indicator for a decentered glenohumeral joint is defined on a true AP radiograph with the patient standing or sitting. The present study therefore evaluated the influence of the patient position by comparing the acromiohumeral distance in both modalities in shoulders with an intact rotator cuff. MethodsOn MRI images and true AP radiographs of patients > 20 and < 80 years with an intact rotator cuff the acromiohumeral distance was measured. The maximum cranio‐caudal size of the glenoid was measured as a reference to allow a direct comparison of both modalities. ResultsTwo‐hundred and thirty‐four shoulders (mean patients age 45.8 ± 14.3 years) were included. The mean acromiohumeral distance/glenoid size ratio of all shoulders was significantly larger (P < 0.0001) on the MRI with 4.6 ± 1.0 in comparison to 4.1 ± 0.9 in the radiographs indicating a smaller acromiohumeral distance on the MRI. In absolute values, a mean acromiohumeral distance of 9.2 mm ± 1.8 on MRI in comparison to 10.4 mm ± 2.4 on the radiographs was calculated. Herewith, the acromiohumeral distance in the MRI was in the average 1.2 mm ± 2.1 (13%) smaller than the in corresponding radiographs (P < 0.0001). ConclusionThe acromiohumeral distance is significantly smaller in the MRI in comparison to AP radiographs in shoulders with an intact rotator cuff and should not be used as a decision criterion on MRI to assess glenohumeral centering or subacromial space width. Level of evidenceIV.

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“…Current evidence supports the reliability of ultrasound and CT or MR measurement [ 34 ]. Reduced AHD is associated with rotator cuff tear [ 34 , 35 ], and some surgeons measure AHD for predicting the success of a rotator cuff tear repair [ 36 ]. Distances smaller than 7 mm are often associated with rotator cuff degenerative disease.…”

Section: Discussionmentioning

confidence: 99%

Increased acromiohumeral distance in a double-row arthroscopic rotator cuff surgery compared to a single-row surgery after 12 months

Turan

Çabuk

Köroğlu³

et al. 2021

J Orthop Surg Res

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Background Arthroscopic rotator cuff surgery is an effective treatment for rotator cuff tears with the considered use of double-row repair techniques becoming popular in the last decade. We aim to compare the effects of double- and single-row arthroscopic rotator cuff repairs (ARCR) on repair integrity (RI) and acromiohumeral distance (AHD). Methods In this observational study, we retrospectively identified 98 patients with degenerative rotator cuff tear treated with arthroscopic rotator cuff repair between 2016 and 2019. We excluded 22 patients with partial-thickness tears, 15 with associated subscapularis or SLAP tears, 13 with massive tears, and 5 patients lost to follow-up; we included 43 patients who had ARCR for full-thickness cuff tear and clinical, radiologic follow-up. Of these 43 patients, 23 are grouped as double-row repair group (DRG) and 20 as single-row repair group (SRG). A minimum of 12 months after the surgery, bilateral shoulder MRIs were obtained. Contralateral shoulders without asymptomatic rotator cuff tears served as a control group (CG). The operating surgeon and two other surgeons experienced in arthroscopy blindly measured the AHD and determined the RI at the control MRIs in all groups. Functional assessments relied on UCLA and qDASH Scores. Results The mean age was 57.89 (45–78) years, and the mean follow-up time was 28,65 (21–43) months. The mean AHD of the CG was 9.7 ± 0.96 mm, the preoperative AHD of DRG was 8.62 ± 1.45 mm, and SRG was 9.71 ± 0.95 mm. The postoperative mean AHD of DRG 9.61 ± 1.83 mm and SRG was 10.21 ± 1.97 mm. AHD differences between the preoperative and postoperative groups were significant (P=0.009). The increase of the AHD in the double-row group was significantly higher than the single-row group (P=0.004). There was a high correlation between the RI and DASH scores (P=0.005). RI did not correlate with the repair method (P=0.580). Conclusion Although double-row repairs can maintain greater AHD than single-row repairs in the clinical setting, this difference did not affect functional results. Regardless of the surgical intervention, functional results are favourable if RI is achieved. Level of evidence Level III, Retrospective Cohort Study

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The accuracy of plain radiographs in diagnosing degenerate rotator cuff disease

Cited by 10 publications

References 18 publications

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis

The acromiohumeral distance in the MRI should not be used as a decision criterion to assess subacromial space width in shoulders with an intact rotator cuff

Increased acromiohumeral distance in a double-row arthroscopic rotator cuff surgery compared to a single-row surgery after 12 months

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