Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder

Abstract

The usefulness of ultrasound measurements in the diagnosis of the subacromial impingement syndrome of the shoulder was evaluated. Fifty-seven patients with unilateral symptoms of the impingement syndrome underwent ultrasound examination of both shoulder joints, which included assessment of rotator cuff integrity, measurement of rotator cuff thickness and the distance between the infero-lateral edge of acromion and the apex of the greater tuberosity of humerus (AGT distance) in the standard ultrasonographic positions. As a control group, 36 volunteers (72 shoulders) with no history of shoulder pain were examined sonographically. Ultrasonographic assessment of humeral head elevation, measured as the AGT distance, proved to be useful in establishing the diagnosis of the subacromial impingement syndrome of the shoulder. A difference in rotator cuff thickness of more than 1.1 mm and a difference in the AGT distance of more than 2.1 mm between both shoulder joints may reflect dysfunction of rotator cuff muscles.

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...…”

“…Eight studies evaluated tendinopathy and symptoms 16, 23, 28, 32, 48, 49, 58, 64 (Tables 1, 2, and 3). Two evaluated the relationship with pain 32, 48, 3 with disability 16, 28, 49, and 7 with both pain and disability 23, 28, 32, 48, 49, 58, 64.…”

“…One low‐quality MRI study found that only a high‐stage tendinopathy, defined by complete disruption of supraspinatus tendon, was associated with symptoms 64. There was no association between RC thickness and symptoms of impingement (pain with functional impairment) between patients in 1 ultrasound study, but a significant difference in RC thickness of >1.1 mm was seen between affected and unaffected shoulders of the same patient 23. Three MRI studies of mixed quality 48, 49, 58 reported no relationship with tendinopathy and symptoms.…”

“…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.…”