Magnetic resonance imaging analysis of the subacromial space in the impingement sign positions

Roberts, Craig S.; Davila, Jeffrey; Hushek, Stephen G.; Tillett, Edward D.; Corrigan, Theresa M.

doi:10.1067/mse.2002.127095

Cited by 58 publications

(32 citation statements)

References 14 publications

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“…Findings from these ultrasound studies were generally consistent with those using MRI to image the SAS, 1,15,19 which depicted the AHD measure of the anterior to middle aspect of the SAS or described it as the smallest distance between the acromion and humerus regardless of location in the SAS. There is evidence of greater humeral contact on the anterior aspect of the acromion 13 and a decrease of the anterior aspect of the SAS with clinical impingement maneuvers 30 ; however, the purpose of this study was not to look at contact or absolute values but to examine the effects of change in AHD with change in posture. Additionally, no evidence indicates that the anterior aspect differs from the posterior aspect with respect to AHD change during arm movement or altered postures.…”

Section: Discussionmentioning

confidence: 99%

Effect of Posture on Acromiohumeral Distance With Arm Elevation in Subjects With and Without Rotator Cuff Disease Using Ultrasonography

Kalra¹,

Seitz²,

Boardman³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Controlled laboratory study. Objectives To examine the effects of altering posture on the subacromial space (SAS) in subjects with rotator cuff disease and subjects without shoulder pain. Background Poor upper quadrant posture has been linked to altered scapular mechanics, which has been theorized to excessively reduce SAS. However, no study has examined the direct effects of altering upper quadrant posture on SAS. We hypothesized that upright posture would increase and slouched posture would decrease the SAS, as compared to a normal posture, when measured both with the shoulder at rest along the side of the trunk and when maintained in 45° of active shoulder abduction. Methods Participants included 2 groups: the subjects with shoulder pain and rotator cuff disease, as diagnosed via magnetic resonance imaging (n = 31), and control subjects without shoulder pain (n = 29). The SAS was imaged with ultrasound using a 7.5-MHz linear transducer placed in the coronal plane over the posterior to midportion of the acromion. The SAS was measured on ultrasound images using the acromiohumeral distance (AHD), defined as the shortest distance between the acromion and the humerus. The AHD was measured in 2 trials at 2 arm angles (at rest along the trunk and at 45° of active abduction) and across 3 postures (normal, slouched, and upright), and averaged for data analysis. Results Two mixed-model analyses of variance, 1 for each arm angle, were used to compare AHD across postures and between groups. There was no interaction between group and posture, and no significant main effect of group for either arm position. There was no significant main effect of posture for the arm at rest (P = .26); however, there was a significant main effect of posture on AHD at the 45° abduction arm angle (P = .0002), with a significantly greater AHD in upright posture (mean AHD, 9.8 mm), as compared to normal posture (mean AHD, 8.6 mm). Conclusion The effect of posture on SAS, as measured by the 2-dimensional AHD using ultrasound of the posterior to middle aspect of the SAS, is small. The AHD increased with upright posture by 1.2 mm compared to normal posture, when the arm was in 45° active abduction. J Orthop Sports Phys Ther2010;40(10):633–640. doi:10.2519/jospt.2010.3155

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Section: Discussionmentioning

confidence: 99%

Effect of Posture on Acromiohumeral Distance With Arm Elevation in Subjects With and Without Rotator Cuff Disease Using Ultrasonography

Kalra¹,

Seitz²,

Boardman³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

View full text Add to dashboard Cite

show abstract

“…These previous studies have measured the subacromial space under in-vivo conditions with various imaging modalities, including three-dimensional (3D) computed tomography (Lochmuller et al, 1997), clinical radiographs (van de Sande and Rozing, 2006,van de Sande et al, 2006,Lehtinen et al, 2000,Petersson and Redlund-Johnell, 1984, ultrasound imaging (Girometti et al, 2006,Azzoni et al, 2004, and MRI (Pappas et al, 2006,Graichen et al, 1998,Graichen et al, 1999b,Graichen et al, 1999a,Graichen et al, 2001,Graichen et al, 2005,Hinterwimmer et al, 2003,Roberts et al, 2002,Solem-Bertoft et al, 1993. Additional studies have estimated the subacromial space width based on shoulder kinematics as measured using skin-mounted sensors (Tsai et al, 2003,Thigpen et al, 2006,Ludewig and Cook, 2002,Nawoczenski et al, 2003.…”

Section: Introductionmentioning

confidence: 99%

In vivo measurement of subacromial space width during shoulder elevation: Technique and preliminary results in patients following unilateral rotator cuff repair

Bey¹,

Brock²,

Beierwaltes³

et al. 2007

Clinical Biomechanics

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Background: The shoulder's subacromial space is of significant clinical interest due to its association with rotator cuff disease. Previous studies have estimated the subacromial space width to be 2-17 mm, but no study has measured in-vivo subacromial space width during shoulder motion. The purpose of this study was to measure the in-vivo subacromial space width during shoulder elevation in patients following rotator cuff repair.

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“…the space between the rotator cuff and the acromion was found to be increased [3]. This makes accurate clinical diagnosis challenging and often to aid the clinician imaging is utilised.…”

Section: Discussionmentioning

confidence: 99%

Inter Observer Variability in the Specificity of Magnetic Resonance Imaging for External Impingement of the Shoulder—Is There Agreement among Radiologists?

Baraza¹,

Goswam²,

Shahban³

2017

OALib

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Purpose: External impingement in the shoulder is a condition characterised by tenderness in the antero-lateral aspect of the shoulder on arm elevation due to an absolute or relative decrease in the subacromial space. Magnetic resonance imaging (MRI) is frequently utilised to confirm the condition and rule out other differential diagnoses. We conducted a study to look at the inter observer variability in specificity of MRI scanning in impingement of the shoulder. Methods: Twenty-six shoulders aged between 20 and 34 who all presented with shoulder instability only were included in the study. Three experienced consultant musculoskeletal radiologists were then asked to comment on the presence or absence of impingement on reviewing their MRI scans. Results: Radiologist 1 (R1) diagnosed 7 shoulders with impingement and 19 shoulders without. Radiologist 2 (R2) observed that 13 shoulders had radiological signs of impingement and 13 did not, and radiologist 3 (R3) suspected impingement in 20 shoulders with 6 shoulders normal. For R1 and R2, the agreement was 0.58 with a kappa value of 0.16. Between R2 and R3, the agreement was also 0.58 with a kappa value of 0.16. Comparing R1 and R3, the agreement was 0.46 and the kappa value was 0.14. Across all three radiologists, there was agreement in 8 out of the 26 MRI scans (31%) but only in 4 out of the 26 (15.4%) did they all agree that impingement was not present. Conclusion: MRI should be used judiciously in the work up of patients with external impingement of the shoulder.

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Magnetic resonance imaging analysis of the subacromial space in the impingement sign positions

Cited by 58 publications

References 14 publications

Effect of Posture on Acromiohumeral Distance With Arm Elevation in Subjects With and Without Rotator Cuff Disease Using Ultrasonography

Effect of Posture on Acromiohumeral Distance With Arm Elevation in Subjects With and Without Rotator Cuff Disease Using Ultrasonography

In vivo measurement of subacromial space width during shoulder elevation: Technique and preliminary results in patients following unilateral rotator cuff repair

Inter Observer Variability in the Specificity of Magnetic Resonance Imaging for External Impingement of the Shoulder—Is There Agreement among Radiologists?

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