Abstract
Subacromial impingement is one of the most common causes of painful shoulder in the middle aged and elderly population. Since Neer’s first description of the process, many investigators have researched this condition in an effort to gain a better understanding of the disease etiology. The aim of this study was to investigate the relationship between the radiological subacromial distance measurements and the subacromial impingement syndrome in a series of patients from our institution. For this purpose, 44 patients scheduled for a unilateral shoulder arthroscopy were investigated prospectively. The acromio-glenoid angle, supraspinatus-glenoid angle (from coronal MR images) and acromial index (from true anterior-posterior shoulder X-ray images) were measured as the implications of the subacromial distance, and the degree of subacromial impingement was graded according to intraoperative findings. Statistical data analysis revealed no significant correlations between the radiological measurements and the severity of subacromial impingement (p > 0.05). On the other hand, there was a significant correlation (p = 0.0049) between the patient age and subacromial impingement. These results suggest that the radiological subacromial distance measurements do not have enough clinical significance as predictive markers in the subacromial impingement syndrome.
Similar content being viewed by others
References
Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA (2006) The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 8:1699–1704
Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M (1995) Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br 2:296–298
Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB (1995) Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1:10–15
Neer CS 2nd (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1:41–50
Bigliani LU, Levine WN (1997) Subacromial impingement syndrome. J Bone Joint Surg Am 12:1854–1868
Nicholson GP, Goodman DA, Flatow EL, Bigliani LU (1996) The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg 1:1–11
Banas MP, Miller RJ, Totterman S (1995) Relationship between the lateral acromion angle and rotator cuff disease. J Shoulder Elbow Surg 6:454–461
Gohlke F, Barthel T, Gandorfer A (1993) The influence of variations of the coracoacromial arch on the development of rotator cuff tears. Arch Orthop Trauma Surg 1:28–32
Mintzer CM, Waters PM, Brown DJ (1996) Glenoid version in children. J Pediatr Orthop 5:563–566
Nove-Josserand L, Edwards TB, O’Connor DP, Walch G (2005) The acromiohumeral and coracohumeral intervals are abnormal in rotator cuff tears with muscular fatty degeneration. Clin Orthop Relat Res 433:90–96
Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C (2006) Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am 4:800–805
Tetreault P, Krueger A, Zurakowski D, Gerber C (2004) Glenoid version and rotator cuff tears. J Orthop Res 1:202–207
Tokgoz N, Kanatli U, Voyvoda NK, Gultekin S, Bolukbasi S, Tali ET (2007) The relationship of glenoid and humeral version with supraspinatus tendon tears. Skeletal Radiol 6:509–514
van de Sande MA, Stoel BC, Rozing PM (2006) Subacromial space measurement: a reliable method indicating fatty infiltration in patients with rheumatoid arthritis. Clin Orthop Relat Res 451:73–79
Lewis JS, Green A, Wright C (2005) Subacromial impingement syndrome: the role of posture and muscle imbalance. J Shoulder Elbow Surg 4:385–392
Levy O, Sforza G, Dodenhoff R, Copeland S (2000) Arthroscopic evaluation of the impingement lesion: pathoanatomy & classification. J Bone Joint Surg Br 82B(suppl III):233
Meyer AW (1931) The minuter anatomy of attrition lesions. J Bone Joint Surg 13:341–360
Seeger LL, Gold RH, Bassett LW, Ellman H (1988) Shoulder impingement syndrome: MR findings in 53 shoulders. AJR Am J Roentgenol 2:343–347
Conflict of interest
We report no possible conflicts of interest with any institutions or companies and also no outside funding or grants, as stated in Conflict of Interest Disclosure Forms. None of the researchers or an affiliated institute received (or agreed to receive) from a commercial entity something of value related in any way to this manuscript or research. Research was performed at Gazi University Hospital, Ankara, Turkey.
Author information
Authors and Affiliations
Corresponding author
Additional information
Disclaimer: We hereby state that all ethical, legal, and patient rights wise considerations were fulfilled during and after this study.
Rights and permissions
About this article
Cite this article
Kanatli, U., Gemalmaz, H.C., Ozturk, B.Y. et al. The role of radiological subacromial distance measurements in the subacromial impingement syndrome. Eur J Orthop Surg Traumatol 23, 317–322 (2013). https://doi.org/10.1007/s00590-012-0960-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-012-0960-9