Os acromiale: frequency and a review of 726 shoulder MRI

Rovesta, Claudio; Marongiu, Maria Carmen; Corradini, Alessandro; Torricelli, Pietro; Ligabue, Guido

doi:10.1007/s12306-017-0463-2

Cited by 15 publications

(21 citation statements)

References 18 publications

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“…12 The most recent evidence using MRI imaging in a cohort of 1042 patients suggests a lower frequency of 3.4%. 13 Examination of Table 1 suggests a spread of frequency from 2.7–15.0% with generally higher frequencies seen in anatomical studies. Of note, Sammarco reports a significant demographic variance.…”

Section: Population Prevalencementioning

confidence: 92%

“…Both anatomical and radiological studies examining the frequency of os acromiale exist in the literature (see Table 1). 5–13 Early anatomical studies from Gruber, and Macalister suggest an incidence ranging from 3% to 15%. 5,6 In the modern literature, Sammarco suggests an incidence of 8% from the examination of 1198 scapulas from the Hamann–Todd osteological collection in Cleveland, USA.…”

Section: Population Prevalencementioning

confidence: 99%

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Os acromiale: a review of its incidence, pathophysiology, and clinical management

2019

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An os acromiale occurs when any of the primary ossification centres of the acromion fail to fuse with the basi-acromion. It is present in approximately 8% of individuals, and whilst the majority of these individuals are unaffected it can cause significant pain and disability. It can impact seemingly unrelated surgical intervention in the region such as subacromial decompression and reverse shoulder arthroplasty. A painful os acromiale can be both a diagnostic challenge, and difficult to manage. There remain a wide variety of surgical practices with variable outcomes achieved. We present an evidence-based discussion of the surgical techniques described to date in the literature, alongside a comprehensive review of the incidence and pathophysiology of os acromiale. This review was written after a comprehensive analysis of the literature to date relating to os acromiale. Particular focus was given to material examining surgical management techniques, and the condition’s incidence across different population groups. Open reduction and internal fixation using cannulated screws, or tension band wiring have superior outcomes in the literature in the treatment of symptomatic os acromiale. There may be a biomechanical advantage of combining the two techniques. Preservation of large anterior deltoid attachment is necessary, with consideration being given to the local blood supply. There is likely no additional benefit from iliac crest vs local bone grafting. Research in this area remains of a low evidence level with small samples sizes. Appropriately powered clinical research of a higher-level evidence methodology is needed in order to differentiate further in the choice of surgical intervention. Cite this article: EFORT Open Rev 2019;4:525-532. DOI: 10.1302/2058-5241.4.180100

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Section: Population Prevalencementioning

confidence: 92%

Section: Population Prevalencementioning

confidence: 99%

Os acromiale: a review of its incidence, pathophysiology, and clinical management

2019

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“…In an adolescent patient presenting with a painful shoulder, it may be difficult to distinguish a normally developing acromion with a secondary ossification center from the early formation of an os acromiale on the basis of age alone. Therefore, MRI and SPECT–CT are receiving more and more attention. Winfeld et al .…”

Section: Methods Of Searchingmentioning

confidence: 99%

Os Acromiale: Reviews and Current Perspectives

You

Frostick

Zhang

et al. 2019

Orthopaedic Surgery

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Os acromiale is a developmental defect which results from the lack of an osseous union between the ossification centers of the acromion, leading to the fibrocartilaginous tissue connection. The prevalence of os acromiale is 1% to 15%, and is quite common in the African American population. Os acromiale in adults is easily diagnosed by symptoms and X‐ray, particularly on the axillary view; however, the differential diagnosis of adolescents may require MRI or SPECT–CT. Generally, nonoperative therapy for symptomatic os acromiale should be started, including physiotherapy, nonsteroidal anti‐inflammatory drugs, and injections. Surgical treatment is indicated after failed conservative treatment. In symptomatic patients with fixable acromiale, the tension band technique should be used to make the anterior aspect of the acromion elevated from the humerus head. In patients with small fragments which are unsuitable for reattachment, excision might be the best therapeutic option and lead to good outcomes. Whether using internal fixation or resection, the arthroscopic technique results in a better outcome and fewer complications, especially in older patients or athletes with overhead movement, because of the high incidence of shoulder impingement or rotator cuff tears which can be treated concurrently.

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“…(15,16).Bizim verilerimiz Türk popülasyonunda Tip I1 akromionun da rotator manşet yırtıklarında etkili olduğunu göstermektedir. Ayrıca literatürde os akromiale çalışmalarında os akromiale varlığının rotator manşet yırtıklarında prevelansı yüksek bulunmuştur (17,18). Bizim çalışmamızda da supraspinatus patolojilerinde os akromiale prevelansı yüksekti.Fakat supraspinatus kası rüptürüyle arasında anlamlı ilişki yokken, sinyal artımı ile arasında anlamlı ilişki mevcuttu.…”

Section: Tartışma Ve Sonuçunclassified

Türk Popülasyonunda Akromion Morfolojisinin Subakromial İmpingement ve Rotator Manşet Yırtıkları ile İlişkisi

Polat¹

2019

GenelTipDer

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ÖzAmaç: Akromion tipleri ve os akromiale varlığının subakromial impingement ve rotator manşet yırtıkları ile ilişkisini manyetik rezonans görüntüleme aracılığıyla incelemeyi amaçladık.Gereç ve Yöntem: 18-85 yaş arasında omuz MR çekimi olan hastalar (n=573) çalışmaya dahil edildi ve cerrahi öyküsü bulunan hastalar (n=34), travma öyküsü ve fraktürü olanlar (n=23) çalışamadan çıkarıldı. 516 hastanın 516 omuz MR çekiminde os akromiale varlığı ve akromion tipleri belirlendi. Supraspinatus kasında impingement bulgusu olarak proton ağırlıklı görüntülerde hiperintens sinyal artımı ve yırtıkları değerlendirildi. Os akromiale varlığı ve akromion tipleri, supraspinatus sinyal artımı ve yırtıkları her hasta için aynı radyolog tarafından belirlendi.Bulgular: Supraspinatus tendonundada sinyal artışı olanlarda os akromiale %4 görülürken, sinyal artışı olmayanlarda %0.008 görüldü. Supraspinatus tendonunda yırtığı olanlarda os akromiale %0.06 görülürken, yırtığı olmayanlarda %0.02 görüldü. Os akromiale ile supraspinatus yırtığı arasında anlamlı ilişki izlenmedi (p=0.055). Os akromiale ile supraspinatus sinyali arasında ise anlamlı ilişki mevcuttu (p=0.043). Akromion tiplerinden Tip I ve Tip III ile supraspinatus sinyal artışı arasında anlamlı ilişki mevcuttu (sırasıyla; p=0.028, p=0.029). Ayrıca, Tip I ve Tip III akromionun supraspinatus tendonu yırtığı ile de anlamlı ilişkisi mevcuttu (sırasıyla; p=0.009, p=0.0061).Sonuç: Tip I ve Tip III akromion subakromial impingement sendromu ve supraspinatus tendon yırtığı açısından risk oluşturmaktadır. Os akromiale varlığıda impingement açısından risk oluşturan bir anatomik varyasyondur.

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Os acromiale: frequency and a review of 726 shoulder MRI

Cited by 15 publications

References 18 publications

Os acromiale: a review of its incidence, pathophysiology, and clinical management

Os acromiale: a review of its incidence, pathophysiology, and clinical management

Os Acromiale: Reviews and Current Perspectives

Türk Popülasyonunda Akromion Morfolojisinin Subakromial İmpingement ve Rotator Manşet Yırtıkları ile İlişkisi

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