The influence of acromioclavicular joint morphology on rotator cuff tears

A comparison of magnetic resonance imaging findings of the acromioclavicular joint in symptomatic versus asymptomatic patients

“…3,10,11 Arthroscopic distal clavicle resection is now a wellaccepted treatment for AC joint arthritis. 1 We have found that, in patients with rotator cuff pathology, the combination of significant AC joint arthritis on MRI with symptoms and physical examination not specific for AC arthritis often makes the decision to perform distal clavicle excision difficult.…”

“…In the asymptomatic group, grading was normal in 18%, mild in 66%, moderate in 12%, and severe in 4%; there was a statistically higher grade of AC arthritis in the symptomatic group (P Ͻ .05). Of the symptomatic individuals, 80% demonstrated reactive bone edema in either the distal clavicle (6), the acromion (3), or both sides of the AC joint (11), whereas no individual in the asymptomatic group had this finding (P Ͻ .05). Reactive bone edema on MRI is a more reliable predictor of symptomatic AC pathology than degenerative changes seen on MRI and, when correlated with clinical examination, is reproducible.…”

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

“…On MRI, possible features of external impingement are a large amount of fluid within the subacromial bursa and medial to the acromioclavicular joint [9], a reduction in the acromiohumeral distance [10], the presence of downward facing acromioclavicular joint osteophytes [11], the shape of the acromion [12] [13] [14], an os acromiale [15] and rotator cuff lesions [16] [17]. However, many of the above lesions have been found in asymptomatic shoulders making radiological diagnosis unreliable.…”

Arthroscopic Distal Clavicle Resection in Symptomatic Acromioclavicular Joint Arthritis Combined With Rotator Cuff Tear

“…Several authors reported a causal relation between inferiorly directed osteophytes on the distal clavicle eliciting impingement and rotator cuff tears. 12,33 However, the factors not associated with the rotator cuff tear included the position of the ACJ within the supraspinatus outlet, as well as ACJ space narrowing. 12 This suggests that the presence of inferiorly directed osteophytes is associated with rotator cuff lesions, rather than age-related ACJ degeneration in the absence of osteophytes.…”

“…12,33 However, the factors not associated with the rotator cuff tear included the position of the ACJ within the supraspinatus outlet, as well as ACJ space narrowing. 12 This suggests that the presence of inferiorly directed osteophytes is associated with rotator cuff lesions, rather than age-related ACJ degeneration in the absence of osteophytes. Therefore, in the setting of RC tears, symptomatic ACJ arthritis without inferiorly directed osteophytes does not seem to be a proper indication for DCR.…”