Added value of combined acromiohumeral distance and critical shoulder angle measurements on conventional radiographs for the prediction of rotator cuff pathology

European Journal of Radiology Open

Magda Marcon¹  Tim Finkenstaedt²  Nadja A. Farshad-Amacker²  Florian A. Huber²  Vincent Grunder³  Quemars M. Hamie³  Erika Ulbrich³  Roman Guggenberger³ 

[1] Corresponding author at: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.;Faculty of Medicine, University of Zurich, Zurich, Switzerland;Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland;

关键词: Acromiohumeral distance;    Critical shoulder angle;    Rotator cuff tear;    Fatty degeneration;    Conventional radiography;    Magnetic resonance arthrography;   

DOI  :  

来源: DOAJ

【 摘 要 】

Purpose: To investigate the role of acromiohumeral distance (AHD) and critical shoulder angle (CSA) measurements from conventional radiographs (CR) in isolation and combined (prognostic index PIAHD-CSA) as predictors of full thickness rotator cuff tendon tears (RCT) and critical fatty degeneration (CFD; i.e. as much fat as muscle). Method: In this retrospective study AHD and CSA were measured in 127 CR. MR arthrograms served as reference standard and were screened for RCT and CFD. Statistical analysis for inter-reader agreement, Spearman’s rank correlation, linear stepwise regression and logistic regression for AHD and CSA with ROC analyses including PIAHD-CSA were performed. Results: In 90 subjects (17 females, mean age 36.1 ± 14.1) no RCT were found on MR imaging and served as control group. In 37 patients (13 females, mean age 58.7 ± 13.2) ≥ one RCT was found. Inter-reader agreements rated between к = 0.42–0.82 for categorical and 0.91–0.96 for continuous variables. No significant correlation of AHD and CSA with either age or sex was seen (p = 0.28 and p = 0.74, respectively). Case group had significantly smaller mean AHD (8.7 ± 3.2 vs. 10.8 ± 2.2 mm; p < 0.001) and larger mean CSA (36.5 ± 4.5° vs. 33.1 ± 4.0°; p < 0.001). PIAHD-CSA increased diagnostic performance for prediction of RCT and CFD (AUC = 0.78 and 0.71), compared to isolated AHD (0.74 and 0.71) and CSA (0.71 and 0.66). Conclusions: AHD and CSA do not depend on age or sex but differ significantly between healthy and pathologic rotator cuffs. A decreased AHD is most influenced by infraspinatus muscle atrophy and fatty degeneration. Combined PIAHD-CSA increases diagnostic performance for predicting RCT and CFD.

【 授权许可】

Unknown