Relation Between Narrowed Coracohumeral Distance and Subscapularis Tears

Richards, David P.; Burkhart, Stephen S.; Campbell, Scot E.

doi:10.1016/j.arthro.2005.06.015

Cited by 143 publications

(100 citation statements)

References 31 publications

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“…CT is not accurate enough to evaluate the tendon. However, we found no decrease in the coracohumeral distance or anterior subluxation of the glenohumeral joint, implying an intact rotator cuff [33]. Second, we did not quantify the strength of the subscapularis muscle in the press belly test [9] and the lift-off test [10].…”

Section: Discussionmentioning

confidence: 65%

Subscapularis Release in Shoulder Replacement Determines Structural Muscular Changes

Wilde

Coninck

Neve

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Osteotomy of the lesser tuberosity in shoulder arthroplasty allows bony healing of the subscapularis tendon but does not prevent fatty degeneration in its muscle. Occurrence or increase in fatty degeneration may depend on the surgical technique. Questions/purposes We (1) assessed fatty degeneration in the subscapularis muscle and its cross-sectional area after a C-block osteotomy of the lesser tuberosity with minimal mobilization of the subscapularis muscle, and (2) determined whether this technique had any adverse effect on function, fatty degeneration, and cross-sectional area of the subscapularis muscle. Methods We retrospectively examined 36 patients with shoulder replacements who had C-block osteotomies. Constant-Murley scores and clinical signs of subscapularis insufficiency were recorded. We radiographically assessed prosthetic placement. On CT scans, lesser tuberosity healing, fatty degeneration, and cross-sectional area of the subscapularis muscle were determined. The minimum followup was 13 months (mean, 18 months; range, 13-33 months).

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Section: Discussionmentioning

confidence: 65%

Subscapularis Release in Shoulder Replacement Determines Structural Muscular Changes

Wilde

Coninck

Neve

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…[8][9][10][11]17,18 Although these reports all largely agree on the patient symptoms and physical examination findings present in coracoid impingement, none has been able to identify a definitive preoperative imaging reference standard for diagnosis, and none of the signs and symptoms described in the literature has demonstrable sensitivity, specificity, or accuracy. 19 Masala et al 5 compared the use of plain radiography, sonography, CT, and MRI to evaluate the CHI in 15 patients with coracoid impingement.…”

Section: Discussionmentioning

confidence: 96%

Sonography of the Coracohumeral Interval

Tracy

Trella

Nazarian

et al. 2010

Journal of Ultrasound in Medicine

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Objective. Coracoid impingement has been recognized as an etiology for anterior shoulder pain; however, no imaging reference standard exists. We used sonography to compare the coracohumeral interval (CHI) in asymptomatic volunteers with the CHI in patients with coracoid impingement. Methods. Bilateral shoulder sonography was performed in 19 asymptomatic volunteers (10 men and 9 women) and in 8 shoulders in 7 patients (6 men and 1 woman) with a clinical diagnosis of coracoid impingement. With the arm adducted across the chest, the interval between the coracoid process and the lesser tuberosity of the humerus was measured using a linear array ultrasound transducer with a peak frequency of 13 MHz. Results. In the asymptomatic volunteers, the mean ± SD for the CHI was 12.2 ± 2.5 mm (range, 7.8-17.5 mm). In the symptomatic shoulders, the mean ± SD for the CHI was 7.9 ± 1.4 mm (range, 5.9-9.6 mm). Repeated measures analysis of variance revealed the CHI to be significantly narrower in symptomatic shoulders than in asymptomatic volunteers (P < .0001). Conclusions. These data suggest a role for sonography in diagnosing coracoid impingement. Key words: coracohumeral interval; coracoid impingement; shoulder. Most commonly, impingement of the supraspinatus tendon occurs deep to the coracoacromial arch. Less commonly, the space between the coracoid and the lesser tuberosity (ie, the coracohumeral interval [CHI]) is too narrow to allow unencumbered passage of the subscapularis tendon.2 This results in the entity known as coracoid impingement, which can be difficult to identify on both physical examination and imaging studies.Cadaveric studies have revealed tremendous variability in the bony anatomy of the coracoid process and subcoracoid recess.3 Plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI) all have been used to evaluate the CHI. [4][5][6] Unfortunately, although plain radiography can provide evidence of classic impingement and degenerative changes, it does not show any specific signs predictive of coracoid impingement.5 Standard CT and MRI allow only static evaluation

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“…Bazı araştırmacılar bu aralığın iç rotasyondaki eşik değerlerini 4 mm ile 6.8 mm arasında değişen miktarlarda bildirmişlerdir 5,16,[19][20][21] Yapmış olduğumuz çalışmaya oldukça benzer diğer bir çalışma ise Hatta ve arkadaşları tarafından 6 hastanın MRG tetkiklerinden elde edilen 3B görüntülerle yapılmıştır 24 . Bu çalışmada korakoidin yüzeyi 6 parçaya ayrılmış ve bir bilgisayar yazılımı kullanılarak bu yüzeylerden humerusa an yakın olan seçilerek ölçüm yapılmıştır.…”

Section: Discussionunclassified

Omuz iç rotasyonunun korakohumeral ve akromiyo aralığa etkisinin üç boyutlu tomografi ile değerlendirilmesi

Çetinkaya

Koçkara

Özer

et al. 2018

Cukurova Medical Journal

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AbstractÖz Purpose: The aim of this study was to assess whether the coracohumeral and acromiohumeral distances were really decreasing with the passive internal rotation of the shoulder. Materials and Methods:The patients who underwent computerized tomography arthrography with the prediagnosis of rotator cuff tear between May 2016 and October 2016 were enrolled in the study. The computerized tomography arthrography imagings were performed in two positions of the shoulder, the neutral position and the internal rotation of the arm, and then the 3 dimensional reconstructions of the images were constituted. The coracohumeral and acromiohumeral distance measurements were made on 3 dimensional reconstructions of these two computerized tomography examinations. Results: Seventeen patients with the mean age of 64.06±9.06 were involved in the study. The coracohumeral and acromiohumeral distance measurements in neutral and internally rotated arms were also statistically similar between patients with fullthickness rotator cuff tears and those without. Between the male and female patients, there was no statistically significant difference in any of measurements. Conclusion:The coraohumeral distance narrows significantly with the internal rotation of the arm. The measurements made on three dimensional computerized tomography may provide us more reliable data about the several parameters of the coracoid process.Amaç: Bu çalışmanın amacı korakohumeral aralık ve akromiyohumeral aralık miktarının omzun pasif iç rotasyonu ile gerçekten azalıp azalmadığını değerlendirmekti Gereç ve Yöntem: Çalışmada Mayıs 2016 ile Ekim 2016 arasında poliklinikte rotator kılıf hasarı ön tanısı ile bilgisayarlı tomografi artrografi çekilen hastalar kullanıldı. Bilgisayarlı tomografi artrografi tetkiki omuz nötral ve iç rotasyonda olmak üzere iki kez yapıldı ve görüntülerin 3 boyutlu rekonstrüksiyonları oluşturuldu. Bu iki bilgisayarlı tomografi tetkikinin 3 boyutlu bilgisayarlı tomografi görüntülerinde korakohumeral aralık ve akromiyohumeral aralık ölçümleri yapıldı. Bulgular: Çalışmaya yaş ortalamaları 64.06±9.06 olan 17 hasta dahil edildi. Tam kat supraspinatus yırtığı olanlarla olmayanlar değerlendirildiğinde, korakohumeral aralık ve akromiyohumeral aralığın omzun nötral ve iç rotasyonundaki ölçümlerinin ortalamaları arasında istatistiksel olarak anlamlı fark görülmedi. Kadın ve erkekler arasında ölçüm ortalaması arasında istatistiksel fark yoktu. Sonuç: Omzun pasif iç rotasyonu ile korakohumeral aralık anlamlı derecede daralmaktadır. Üç boyutlu bilgisayarlı tomografi ile yapılan ölçümler korakoid anatomisi ve korakoidin çeşitli parametreleri ile ilgili bize daha güvenilir bilgi verebilirler.

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Relation Between Narrowed Coracohumeral Distance and Subscapularis Tears

Cited by 143 publications

References 31 publications

Subscapularis Release in Shoulder Replacement Determines Structural Muscular Changes

Subscapularis Release in Shoulder Replacement Determines Structural Muscular Changes

Sonography of the Coracohumeral Interval

Omuz iç rotasyonunun korakohumeral ve akromiyo aralığa etkisinin üç boyutlu tomografi ile değerlendirilmesi

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