Critical shoulder angle is intrinsically associated with the development of degenerative shoulder diseases: A systematic review

Abstract

Aim of this study was to investigate the potential influence of Critical Shoulder Angle (CSA) as a predisposing factor for the development of degenerative full-thickness rotator cuff tears (DRCT) or primary glenohumeral osteoarthritis (PGOA). A systematic review of the Pubmed, Scopus, Mendeley, ScienceDirect and the Cochrane Central Register of Controlled Trials online databases was performed for literature regarding CSA and its association with DRCT and PGOA. In order to evaluate solely the relationship between CSA as a predisposing factor for the development of the aforementioned degenerative shoulder diseases (DSDs), we precluded any study in which traumatic cases were not clearly excluded. Our search strategy identified 289 studies in total, nine of which were eligible for inclusion based on our pre-established criteria. Quality assessment contacted using the Newcastle Ottawa Scale for case-control studies. There were a total of 998 patients with DRCT and 285 patients with PGOA. The control groups consisted of a total of 538 patients. The mean CSA ranged from 33.9° to 41.01° for the DRCT group, from 27.3° to 29.8° for the PGOA group and from 30.2° to 37.28° for the control group. All studies reported statistically significant differences between the DRCT and PGOA groups and the respective control groups. Our study results showed that there is moderate evidence in the literature supporting an intrinsic role of CSA in the development of DSDs. Level of evidence: IV. Systematic review of diagnostic studies, Level II-IV.

Evaluation of MR-derived simulated CT-like images and simulated radiographs compared to conventional radiography in patients with shoulder pain: a proof-of-concept study

“…While MR-derived CT-like images provided additional information on the osseous structures of the glenohumeral joint in our study, the creation of simulated radiographs may be an important technique in order to acquire radiation-free radiograph-like images of the glenohumeral joint, especially in young patients if no radiograph or CT has been performed previously. Semi-quantitative shoulder joint assessment scores and angle measurements performed using simulated radiograph-like images may be useful for the evaluation of the osseous structures of the shoulder for therapy planning and monitoring [ 20 ]. This MR-based technique may lead to less use of conventional radiographs and CT scans in the future, since the diagnostic information could be acquired in one examination using MR imaging.…”

A lower critical coracoid process angle is associated with type-B osteoarthritis: a radiological study of normal and diseased shoulders

“…Increasing evidence has indicated that underlying coronal plane variation is implicated in the progression of shoulder degeneration to either OA or RCTs, with previous findings with respect to the CSA replicated in this study. 8 , 10 , 18 , 19 , 33 , 34 , 39 , 47 , 53 , 57 This article sought to further understanding of axial plane scapular morphology and association with posterior wear patterns of OA. Glenoid RV has been suggested to be associated with posterior subluxation of the humeral head and type-B glenoid pattern of degenerative wear.…”

“…This sample size was reached based on similar studies conducted. 34 , 43 , 47 , 49 Group characteristics were defined by the scans displaying type-B2 OA, rarest of the studied pathologies. Twenty B2 glenoids were added to 20 B1 glenoids chosen by order of the scan date, to create a group of 40 type-B glenoids.…”

“… 34 A higher CSA (>35˚) has been strongly associated with RCTs. 10 , 18 , 19 , 34 , 39 , 47 , 53 , 57 Conversely, a lower CSA (<30˚) is found in patients with OA. 8 , 19 , 33 , 39 , 47 , 52 …”

“… 10 , 18 , 19 , 34 , 39 , 47 , 53 , 57 Conversely, a lower CSA (<30˚) is found in patients with OA. 8 , 19 , 33 , 39 , 47 , 52 …”