Acromion types and morphometric evaluation of painful shoulders
, 2, 3, 4, 2, 2
Abstract
Background: Due to its many variations, the scapula is among the most frequently examined bones. Especially the acromion can be of different shapes and sizes. Measurements of the morphometric structures in the shoulder joint make it easier to explain the cause of the various shoulder problems. The objective of this study is putting emphasis on the importance of acromion types, os acromiale presence and acromial morphometric measurements in the aetiology and diagnosis of shoulder pain.
Materials and methods: A retrospective study, based on 100 patients of both genders who presented with the complaints of shoulder pain and underwent magnetic resonance imaging, was conducted. Within this scope, types of acromion, slope of acromion, length of acromion, length of coracoid process, the distance between acromion and coracoid process, lateral acromial angle (LAA), critical shoulder angle (CSA), acromial index (AI) and acromiohumeral distance were measured. The data were analysed considering the gender and acromion types and the presence of os acromiale is investigated.
Results: The most common acromion was type II (curved) (frequency rate 62%) while the rate of type I (flat) and type III (hooked) acromions were 21% and 17%, respectively. The length of acromion and coracoid process were found to be significantly longer in males, while no significant difference between genders in terms of the distance between acromion and coracoid process were observed. Furthermore, while negative correlation between LAA and AI as well as LAA and CSA were observed; positive correlation between AI and CSA was found. In addition, there was negative correlation between slope of acromion and acromiohumeral distance. Besides, acromiohumeral distance was significantly higher in males. Regarding the presence of os acromiale, it was observed in 3 women out of 59 and 2 men out of 41, which indicated no significant difference between genders.
Conclusions: It is evaluated that the morphometric measurement is of importance in contributing clinically in distinguishing the problems that may occur according to gender and acromion types.
Keywords: acromionmorphometric measurementshoulder jointsubacromial impingement syndrome
References
- Anetzberger H, Putz R. The scapula: principles of construction and stress. Acta Anat (Basel). 1996; 156(1): 70–80.
- Aragão JA, Silva LP, Reis FP, et al. Analysis on the acromial curvature and its relationships with the subacromial space and types of acromion. Rev Bras Ortop. 2014; 49(6): 636–641.
- Balke M, Schmidt C, Dedy N, et al. Correlation of acromial morphology with impingement syndrome and rotator cuff tears. Acta Orthop. 2013; 84(2): 178–183.
- Boyan N, Ozsahin E, Kizilkanat E, et al. Assessment of Scapular Morphometry. Int J Morphol. 2018; 36(4): 1305–1309.
- Costa AO, Albuquerque PF, Albuquerque Pde, et al. Morphometric analysis of the scapula and their differences between females and males. Int J Morphol. 2016; 34(3): 1164–1168.
- Edelson JG, Taitz C. Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion. J Bone Joint Surg Br. 1992; 74(4): 589–594.
- Edelson JG, Zuckerman J, Hershkovitz I. Os acromiale: anatomy and surgical implications. J Bone Joint Surg Br. 1993; 75(4): 551–555.
- Gagey N, Ravaud E, Lassau JP. Anatomy of the acromial arch: correlation of anatomy and magnetic resonance imaging. Surg Radiol Anat. 1993; 15(1): 63–70.
- Hurst SA, Gregory TM, Reilly P. Os acromiale: a review of its incidence, pathophysiology, and clinical management. EFORT Open Rev. 2019; 4(8): 525–532.
- Khan Y, Nagy MT, Malal J, et al. The painful shoulder: shoulder impingement syndrome. Open Orthop J. 2013; 7: 347–351.
- Li X, Xu W, Hu N, et al. Relationship between acromial morphological variation and subacromial impingement: A three-dimensional analysis. PLoS One. 2017; 12(4): e0176193.
- Mellado JM, Calmet J, Domènech S, et al. Clinically significant skeletal variations of the shoulder and the wrist: role of MR imaging. Eur Radiol. 2003; 13(7): 1735–1743.
- Michener L, McClure P, Karduna A. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clin Biomech. 2003; 18(5): 369–379.
- El-Din WA, Ali MH. A morphometric study of the patterns and variations of the acromion and glenoid cavity of the scapulae in Egyptian population. J Clin Diagn Res. 2015; 9(8): AC08–AC11.
- Neviaser RJ, Neviaser TJ. Observations on impingement. Clin Orthop Relat Res. 1990(254): 60–63.
- Nicholson G, Goodman D, Flatow E, et al. The acromion: Morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg. 1996; 5(1): 1–11.
- Paraskevas G, Tzaveas A, Papaziogas B, et al. Morphological parameters of the acromion. Folia Morphol. 2008; 67(4): 255–260.
- Park H, Lee S, Choi Y, et al. Association between subacromial impingement and acromiohumeral distance on MRI. Iranian J Radiol. 2018; 15(2).
- Picavet H, Schouten J. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study. Pain. 2003; 102(1): 167–178.
- Saupe N, Pfirrmann CWA, Schmid MR, et al. Association between rotator cuff abnormalities and reduced acromiohumeral distance. Am J Roentgenol. 2006; 187(2): 376–382.
