Comparison of measurements of the glenopolar angle in 3D CT reconstructions of the scapula and 2D plain radiographic views

Suter, Thomas; Henninger, Heath B.; Zhang, Y.; Wylie, James D.; Tashjian, Robert Z.

doi:10.1302/0301-620x.98b11.37800

Cited by 17 publications

(11 citation statements)

References 35 publications

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“…In fact, parallel to our findings, studies on the glenoid inclination and the glenopolar angle also suggested superiority of 3D over 2D measurements. 9 , 32 Measurements of such parameters can also potentially benefit from anatomic point cross-referencing combined with ZTE MRI as described in this study.…”

Section: Discussionmentioning

confidence: 99%

Optimization of the Grashey View Radiograph for Critical Shoulder Angle Measurement: A Reliability Assessment With Zero Echo Time MRI

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Yaraşır

Huri

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Suboptimal positioning on Grashey view radiographs may limit the prognosticating potential of the critical shoulder angle (CSA) for shoulder disorders. Purpose: To investigate whether radiography optimized according to the latest research is reliable for measuring CSA in comparison with magnetic resonance imaging (MRI) featuring 3-dimensional (3D) zero echo time (ZTE) sequencing, which accentuates the contrast between cortical bone and surrounding soft tissue with high fidelity. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Patients with shoulder pain were prospectively and consecutively enrolled. All patients had Grashey view radiographs as well as 3.0-T MRI scans with isotropic 3D ZTE sequencing. Acceptable positioning on the radiographs was determined using the ratio of the transverse to longitudinal (RTL) diameter of the lateral glenoid outline; radiographs with an RTL ≥0.25 were repeated. Two observers independently measured the CSA on the radiographs and the coronal oblique reformatted ZTE images, the latter including verification of measurement points by cross-referencing against images from other planes. Reliability of measurements between observers and modalities was analyzed with the intraclass correlation coefficient (ICC). The paired-samples t test was used to compare the differences between imaging modalities. Results: Enrolled were 65 patients (35 female and 30 male; mean age, 40.2 years; range, 25-49 years). Radiographs with optimal positioning (RTL < 0.25) were attained after a mean of 1.6 exposures (range, 1-4); the mean RTL was 0.09 (range, 0-0.20). Interobserver agreement of CSA was excellent for radiographs (ICC = 0.91; 95% CI, 0.84-0.94) and good for ZTE MRI scans (ICC = 0.85; 95% CI, 0.71-0.92). Intermodality agreement of CSA between radiographs and ZTE MRI scans was moderate (ICC = 0.66; 95% CI, 0.48-0.73). The CSA was significantly different between an optimal radiograph (30.7° ± 4.3°) and ZTE MRI scan (31.8° ± 3.8) ( P = .005). Subgroup analysis revealed no significant differences in CSA measurement between ZTE MRI scans and Grashey view radiographs with an RTL of <0.1 ( P = .08). Conclusion: CSA measurement on ZTE MRI scans with anatomic point cross-referencing was significantly different from that on Grashey view radiographs, even with optimal positioning, and radiography may necessitate more than 1 exposure. An RTL of <0.1 ensured reliability of radiographs when other standards of sufficient x-ray exposure were met.

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Section: Discussionmentioning

confidence: 99%

Optimization of the Grashey View Radiograph for Critical Shoulder Angle Measurement: A Reliability Assessment With Zero Echo Time MRI

Yıldız

Yaraşır

Huri

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…These concepts of reliability and viewing-perspective malrotation are not unfamiliar in other shoulder diagnostic criteria. Our group has also quantified these effects on glenoid inclination 6 and the glenopolar angle 7 and proposed viewing-perspective criteria for lateralview radiographs. 8 Similar viewing-perspective criteria were proposed for anteroposterior radiographs of the scapula.…”

Section: See Related Article On Page 438mentioning

confidence: 99%

“…9 From the underlying 3D morphology, the "true" angles can be quantified to identify the relations between 2-dimensional and 3D measures such as glenoid inclination and the glenopolar angle. 6,7 Regarding CSA, the 3D measures must be evaluated in the context of the critical acromial point to determine where on the The ratio of the transverse (T) to longitudinal (L) diameter of the glenoid projection (RTL) is shown on a scapula at varied viewing perspectives. (A) Per the Suter-Henninger criteria, 2 an A1 view shows the glenoid in profile with the coracoid overlapping the superior rim of the glenoid.…”

Section: See Related Article On Page 438mentioning

confidence: 99%

Editorial Commentary: Is Your Critical Shoulder Angle Accurate? Only If You Can Verify That You Have the Correct Images

Henninger

Suter

Chalmers

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The critical shoulder angle (CSA) has been the focus of significant research related to the etiology and prognosis of rotator cuff tears in recent years, but the accuracy of CSA measurements on plain anteroposterior (Grashey) radiographs has been questioned. Research to better understand what qualifies as a "tolerable" radiograph for reliable measurement of the CSA can inform best practices for obtaining plain radiographs. Optimal measurements rely on optimal images, and knowing how much room for error there is regarding malrotation provides surgeons with unbiased criteria to rule out inadequate images.

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“…First, Digital Imaging and Communications in Medicine (DICOM) data from CT scans of the shoulders will be used to reconstruct 3D scapulae by Mimics (Materialise, Leuven, Belgium). Then, the 3D model will be imported into Blender (Amsterdam, Netherlands) and aligned to the local coordinate system according to the same criteria as described by Suter et al [28]. Lastly, the CSA, which is measured as the angle between a line connecting the inferior border of the glenoid with the most inferolateral point of the acromion and another connecting inferior and superior glenoid margin [12], will be measured on anterior view using Blender (Fig.…”

Section: Primary Outcomementioning

confidence: 99%

Effect of arthroscopic acromioplasty on reducing critical shoulder angle: a protocol for a prospective randomized clinical trial

Long

Hou

Tang

et al. 2020

BMC Musculoskelet Disord

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Background The critical shoulder angle (CSA), which helps to predict patients who are at risk of rotator cuff tears (RCTs) with large degree and who are susceptible to osteoarthritis with low angle, has been identified as one of the most vital acromial parameters; anterolateral and lateral acromioplasties have been proven to be valid ways to reduce CSA. However, no study has compared the effect of different acromioplasties on the reduction of the large CSA (≥33°) clinically. Additionally, either anterolateral or lateral acromioplasty could not precisely correct large CSAs to a favorable range (30–33°) in each patient. Thus, we will propose a novel precise acromioplasty technique for the purpose of reducing CSA accurately and effectively, and compare the effectiveness of different acromioplasties on the reduction of the CSA. Methods A total of 60 RCT patients who have indications for arthroscopic rotator cuff repair and with pre-operative CSA ≥33° will be recruited in outpatient center of Sun Yat-sen Memorial Hospital. Eligible participants will be randomly allocated to Group A (anterolateral acromioplasty), Group B (lateral acromioplasty) or Group C (precise acromioplasty) via a random, computer-generated number system. Three surgical plans will be made for each participant respectively by one professional surgeon according to the results of randomization allocation. The post-operative CSA will be measured 2 days post-operation. Follow-up will be maintained at 3, 6, and 12 months after surgery including the visual analog scale score, the University of California at Los Angeles score, the Constant Shoulder Score and the American Shoulder and Elbow Surgeon Shoulder Assessment Form. Finally, all outcomes will be assessed by two researchers who are blinded to the recruitment and allocation. Discussion This is the first clinical trial to evaluate the impact of different acromioplasties on the reduction of the CSA. Additionally, this study will provide a new precise acromioplasty technique, which is a novel precision and individualized treatment to prevent degenerative RCTs by reducing the CSA. Trial registration ChiCTR2000032343. Registered on April 26th, 2020.

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Comparison of measurements of the glenopolar angle in 3D CT reconstructions of the scapula and 2D plain radiographic views

Cited by 17 publications

References 35 publications

Optimization of the Grashey View Radiograph for Critical Shoulder Angle Measurement: A Reliability Assessment With Zero Echo Time MRI

Optimization of the Grashey View Radiograph for Critical Shoulder Angle Measurement: A Reliability Assessment With Zero Echo Time MRI

Editorial Commentary: Is Your Critical Shoulder Angle Accurate? Only If You Can Verify That You Have the Correct Images

Effect of arthroscopic acromioplasty on reducing critical shoulder angle: a protocol for a prospective randomized clinical trial

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