Correlation between anatomy of the scapula and the incidence of rotator cuff tear and glenohumeral osteoarthritis via radiological study

Miswan, Mohd Fairudz bin Mohd; Saman, Mohd Shahril bin Ahmad; Teo, Seow Hui; Al-Fayyadh, Mohamed Zubair Mohamed; Ali, Mohamed Razif Bin Mohamed; Min, Ng Wuey

doi:10.1177/2309499017690317

Cited by 30 publications

(28 citation statements)

References 12 publications

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“…Although the above studies supported an association between a decreased CSA and the development of osteoarthritis, we are not aware of any prospective studies that have suggested causation 6,22,25,28,30,31 . It is believed that as the CSA decreases, forces on the deltoid shift, causing the forces on the glenohumeral joint to become more compressive, thereby resulting in higher loading of the cartilage and subsequent osteoarthritis.…”

Section: Shoulder Osteoarthritis and Csamentioning

confidence: 84%

“…Additionally, both Moor et al and Heuberer et al demonstrated that the combined risk factors of age and CSA were highly predictive of degenerative rotator cuff tears 25,26 . Multiple subsequent studies have reaffirmed this relationship between a CSA of .35°and the incidence of atraumatic rotator cuff tears 22,24,[28][29][30][31] .…”

Section: Critical Shoulder Anglementioning

confidence: 87%

“…as associated with osteoarthritis, but, because of the retrospective nature of the study, they were unable to find a causative relationship between the CSA and osteoarthritis. However, several subsequent studies have shown, with strong interobserver and intraobserver reliability, that a CSA of ,30°has a significant association with osteoarthritis 22,25,28,30,31 . Heuberer et al 25 , in a retrospective matched-cohort study of 1,000 patients with and without shoulder osteoarthritis, found that the CSA in the osteoarthritis group was significantly smaller than that in the control group (p , 0.001).…”

Section: Shoulder Osteoarthritis and Csamentioning

confidence: 99%

“…When compared with other acromial metrics such as the lateral acromial angle, the acromial index, or the acromioglenoid angle, the CSA has been found to be a more discriminatory metric for distinguishing between shoulders with degenerative full-thickness tears and control shoulders by producing the largest area under the ROC curve and the highest levels of sensitivity and specificity 25,26,28 . Additionally, both Moor et al and Heuberer et al demonstrated that the combined risk factors of age and CSA were highly predictive of degenerative rotator cuff tears 25,26 .…”

Section: Critical Shoulder Anglementioning

confidence: 99%

“…Measurements such as glenoid inclination and lateral extension of the acromion have been studied to determine whether there is a relationship between osseous anatomy and the development of osteoarthritis over time, but no statistical difference was seen when these measurements were compared between arthritic and control subjects 6,15 . Recently, in continued attempts to better understand the etiology of glenohumeral osteoarthritis, attention has been paid to the CSA, which has been shown to be significantly different when patients with osteoarthritis have been compared with controls without osteoarthritis 6,22,25,28,30,31 .…”

Section: Shoulder Osteoarthritis and Csamentioning

confidence: 99%

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Relationship Between the Critical Shoulder Angle and Shoulder Disease

Olszewski

Abdul-Rassoul

et al. 2018

JBJS Rev

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» In this review, we describe the history of the Critical Shoulder Angle (CSA), the utility of the CSA in identifying rotator cuff tears and glenohumeral osteoarthritis, and the association between the CSA and patient-reported outcomes. Additionally, we address some of the controversies surrounding the CSA with an updated literature review. » The CSA is the angle between the plane of the glenoid fossa (the line from the inferior edge of the glenoid to the superior edge of the glenoid) and a line drawn from the inferior edge of the glenoid to the lateral edge of the acromion on a true anteroposterior (Grashey) shoulder radiograph. » An increased CSA (.35°) is thought to alter deltoid vectors, which results in increased superior shear forces on the rotator cuff muscles. This increased loading of the rotator cuff may be a risk factor for the development of rotator cuff tears. » A decreased CSA (,30°) is associated with glenohumeral arthritis due to the increased compressive forces across the glenohumeral joint. » Reports in the literature have both supported and refuted the associations between the CSA, shoulder disease, and clinical treatment outcomes. These conflicting findings may be attributable to the lack of standardized radiographic methods for measuring CSA and/or to measurement errors. » Prospective longitudinal cohort studies involving a standard and reproducible method of CSA measurement are needed to elucidate the true relationship between the CSA and shoulder disease. Disclosure: No external funding was used for this study. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work and "yes" to indicate that the author had other relationships or activities that could be perceived to influence, or have the potential to influence, what was written in this work (http://links.lww.com/JBJSREV/A359).

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Section: Shoulder Osteoarthritis and Csamentioning

confidence: 84%

Section: Critical Shoulder Anglementioning

confidence: 87%

Section: Shoulder Osteoarthritis and Csamentioning

confidence: 99%

Section: Critical Shoulder Anglementioning

confidence: 99%

Section: Shoulder Osteoarthritis and Csamentioning

confidence: 99%

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Relationship Between the Critical Shoulder Angle and Shoulder Disease

Olszewski

Abdul-Rassoul

et al. 2018

JBJS Rev

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Anatomy and Variations

Hirtler

2022

Congenital and Acquired Deformities of the Pediatric Shoulder Girdle

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High performance of critical shoulder angle for diagnosing rotator cuff tears on radiographs

Song¹,

Yun

Song³

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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PurposePrevious studies have reported that a high critical shoulder angle (CSA) is associated with rotator cuff tears (RCTs). However, the available evidence concerning the strength of the association of these parameters with the pathogenesis of RCTs is conflicting. The aim in the present meta‐analysis was to assess the diagnostic performance of CSA for detecting RCTs. MethodsThe PubMed and EMBASE databases were searched for diagnostic accuracy studies of CSA for detecting RCT. Quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. We calculated the pooled diagnostic accuracy of CSA, including diagnostic odd ratios (DORs) with 95% confidence intervals (CIs). Bivariate random‐effect modeling with forest plots and hierarchical summary receiver operating characteristic curves was performed to evaluate the pooled sensitivity and specificity of CSA. For heterogeneity exploration, we performed meta‐regression analyses. ResultsEight studies including 902 patients (460 patients with RCT and 442 control patients) were included. According to DOR, CSA was an informative feature for RCT (DOR 8; 95% CI 4–16). The overall diagnostic performance of CSA for RCT was good (sensitivity 71% [95% CI 61–80%]; specificity, 77% [95% CI 65–86%]). Meta‐regression analyses revealed that the sensitivity of CSA could be higher for differentiating full‐thickness RCTs and normal patients. Furthermore, the specificity of CSA could be higher using a cut‐off value of 35°. ConclusionCSA on plain radiographs has good diagnostic performance for RCTs. A cut‐off value of 35° is recommended for more accurate diagnosis of full‐thickness RCTs. Measuring CSA on plain radiographs may provide clinicians with a readily available and reliable method for detecting RCT in daily practice. Level of evidenceDiagnostic studies, Level III.

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Correlation between anatomy of the scapula and the incidence of rotator cuff tear and glenohumeral osteoarthritis via radiological study

Abstract: The AGA method of measurement is an excellent predictive parameter for diagnosing RCT and GHOA.

Cited by 30 publications

References 12 publications

Relationship Between the Critical Shoulder Angle and Shoulder Disease

Relationship Between the Critical Shoulder Angle and Shoulder Disease

Anatomy and Variations

High performance of critical shoulder angle for diagnosing rotator cuff tears on radiographs

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