Glenohumeral osteoarthritis: what the surgeon needs from the radiologist

Silva, Flavio Duarte; Ramachandran, Shyam; Chhabra, Avneesh

doi:10.1007/s00256-022-04206-2

Cited by 9 publications

(11 citation statements)

References 49 publications

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“…Exclusion criteria were carefully established, including evident indications of advanced glenohumeral osteoarthritis (Kellgren–Lawrence grade of > °II) [ 16 ], instances of humeral head necrosis, the presence of open epiphyseal plates, recent or consolidated fractures involving the humeral head or glenoid, acromioclavicular joint disruptions, a history of shoulder joint total endoprosthesis implantation, and technically inadequate MRI or ultrasound examinations.…”

Section: Methodsmentioning

confidence: 99%

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

Schamberger,

Grossner,

Fischer

et al. 2024

Diagnostics

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Background: An increased or decreased critical shoulder angle (CSA) is a known risk factor for osteoarthritis, lesions, and re-ruptures in the rotator cuff. A CSA greater than 35° correlates with degenerative rotator cuff tears, while a CSA of less than 30° correlates with osteoarthritis in the glenohumeral joint. The diagnostic gold standard for its determination is X-ray or MRI. Objectives: The primary objective of this research was to assess the viability of utilizing sonography imaging as a diagnostic tool to determine the modified critical shoulder angle (mCSA). This study aimed to investigate the feasibility and effectiveness of sonographic techniques in accurately diagnosing CSA compared to MRI. Study Design and Methods: A cohort study was carried out (level of evidence 3). The CSA (MRI) and the mCSA (ultrasound) were assessed retrospectively by two independent board-certified investigators in 109 patients with shoulder pain by MRI and musculoskeletal sonography. The CSA in the MRI dataset was determined using routine protocols and then compared to the values assessed using the modified sonography-assisted method (mCSA). Both results were analyzed with linear regression to determine a possible correlation. All investigations were performed by a DEGUM (German Society for Medical Ultrasound)-certified specialist in musculoskeletal sonography. Results: A total of 112 patients were included in this study, namely 40 female patients and 72 male patients with a mean age of 54.7 years at the time of the investigation. The mean CSA in MRI was 31.5° ± 3.899, and the mCSA in sonography was 30.1° ± 4.753. The inter- and intraobserver reliability for the CSA was factual with values of 0.993 and 0.967. The inter- and intraobserver reliability for mCSA was factual as well, with values of 0.989 and 0.948. The ANOVA analysis did not reveal a significant difference between the CSA and the mCSA values, and linear regression determined the R2 value to be 0.358 with p < 0.05. Conclusions: Diagnosing the mCSA using sonography is a safe and valid method. No statistically significant differences between the results in MRI and sonography could be seen. Although this is a retrospective, single-center study including only Caucasian mid-Europeans, and with the known limitations of ultrasound imaging, it nevertheless shows that sonography can be used as a simple, cheap, and fast technique to assess a modified CSA, which shows very good correlation with the standard CSA without losing the diagnostic quality.

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Section: Methodsmentioning

confidence: 99%

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

Schamberger,

Grossner,

Fischer

et al. 2024

Diagnostics

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“…Imaging studies included conventional AP, alar, and axillary shoulder radiographic views, MRI, and CT scans [17, 18]. GHOA according to the Samilson and Prieto [19] classification was evaluated using radiographs.…”

Section: Methodsmentioning

confidence: 99%

Comprehensive arthroscopic management without axillary nerve release or subacromial decompression achieves satisfactory and durable results in young patients with glenohumeral osteoarthritis

López-Fernández

Luengo-Alonso

Valencia

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose The comprehensive arthroscopic management (CAM) procedure is a useful joint-preserving option for young or active patients with glenohumeral osteoarthritis (GHOA). Our objective was to evaluate the results and prognostic factors of the CAM procedure without direct axillary nerve release or subacromial decompression. Methods A retrospective observational study among patients with GHOA who underwent the CAM procedure was conducted. Neither axillary nerve neurolysis nor subacromial decompression was performed. Both primary and secondary GHOA were considered; the latter was deined as a history of shoulder pathology (mainly instability or proximal humerus fracture). The American Shoulder and Elbow Surgeons scale, Simple Shoulder Test, Visual Analogue Scale, activity level, Single Assessment Numeric Evaluation, EuroQol 5 Dimensions 3 Levels, Western Ontario Rotator Cuf Index, and active range of motion (aROM) were analysed. Results Twenty-ive patients who underwent the CAM procedure met the inclusion criteria. After a mean follow-up of 42.4 ± 22.9 months, we found improvement (p < 0.001) in all postoperative values of the diferent scales. The procedure increased aROM overall. Patients with arthropathy due to instability showed worse results. The rate of CAM failures, deined as conversion to shoulder arthroplasty, was 12%. Conclusions This study showed that the CAM procedure without direct axillary nerve neurolysis or subacromial decompression might be a valid alternative in active patients with advanced GHOA to improve shoulder function (aROM and scores), decrease pain, and delay arthroplasty. This technique showed good subjective functional scores, high patient satisfaction, and a low rate of complications. Level of evidence IV.

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“…По данным, приведенным в обзоре F. Silva и соавт. [13], распространенность первичного ОА ПС достигает 16,1-17,4%, вторичного -1,3-1,5%. Российские данные по эпидемиологии ОА ПС отсутствуют.…”

Section: остеоартрит плечевого (гленохумерального) суставаunclassified

“…Типичным является прогрессирующее нарушение функции; при этом, если на начальных стадиях заболевания в первую очередь страдает ротация (внутренняя и наружная), то при формировании тяжелых структурных изменений сустава снижается объем любых движений -ротации, сгибания, отведения. Нередко пациенты предъявляют жалобы на хруст при движениях в ПС [7,10,13,14].…”

Section: остеоартрит плечевого (гленохумерального) суставаunclassified

“…Как было отмечено выше, общепризнанные диагностические критерии ОА ПС пока не разработаны. Поэтому диагноз этого заболевания может быть установлен при наличии характерной клинической картины («механическая» и «стартовая» боль, прогрессирующее нарушение функции, хруст при движении) и типичных рентгенологических изменений (сужение суставной щели, остеофиты, субхондральный склероз) [7,10,13,14].…”

Section: остеоартрит плечевого (гленохумерального) суставаunclassified

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Osteoarthritis of “atypical” localization: Epidemiology, clinical manifestations, principles of therapy

Karateev,

Nesterenko,

Bialik

et al. 2024

Naučno-praktičeskaâ revmatologiâ

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The problem of osteoarthritis (OA), the most common chronic rheumatic disease, is usually considered in relation to three groups of joints – knee, hip and hands. However, OA can affect any joints of the human body, causing pathological changes characteristic of this nosological form: destruction of joint tissue associated with mechanical stress, chronic inflammation and degenerative processes (neoangiogenesis, fibrosis, heterotopic ossification). This review examines 5 “atypical” OA localizations – shoulder, acromioclavicular, elbow, ankle and foot. The defeat of these joints is observed quite often: shoulder – about 15%, ankle – 3–5%, foot joints – 17% of the inhabitants of the modern population. The main risk factors for this disease are injuries, repeated significant stress, instability and deformities of the joints. The clinic is typical for OA and is manifested by “mechanical” and “starting” pains, stiffness, increasing dysfunction, crunching and deformation. In some cases, persistent synovitis is noted, accompanied by pain at rest and at night. Generally recognized criteria for OA of “atypical” localization have not yet been developed, therefore, its diagnosis is based on the presence of characteristic complaints, typical radiological changes (narrowing of the articular gap, subchondral sclerosis, osteophytes) and the exclusion of other pathology that can cause joint damage. Treatment of this pathology should be complex and include the combined use of non-drug methods (orthosis, physical therapy, physiotherapy) and pharmacological agents, such as nonsteroidal anti-inflammatory drugs, slow-acting symptomatic agents and local injection therapy (intra-articular administration of glucocorticoids, hyaluronic acid, platelet-enriched plasma). When conservative therapy is ineffective, a wide range of surgical interventions is used, from arthroscopic chondroplasty to total endoprosthetics.

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Glenohumeral osteoarthritis: what the surgeon needs from the radiologist

Cited by 9 publications

References 49 publications

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

Comprehensive arthroscopic management without axillary nerve release or subacromial decompression achieves satisfactory and durable results in young patients with glenohumeral osteoarthritis

Osteoarthritis of “atypical” localization: Epidemiology, clinical manifestations, principles of therapy

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