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Published in: Skeletal Radiology 9/2015

01-09-2015 | Scientific Article

A new method for measurement of subcoracoid outlet and its relationship to rotator cuff pathology at MR arthrography

Authors: N. A. Porter, J. Singh, B. J. Tins, R. K. Lalam, P. N. M. Tyrrell, V. N. Cassar-Pullicino

Published in: Skeletal Radiology | Issue 9/2015

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Abstract

Objective

Orthopaedic surgical studies have shown that variations in the vertical distance between the tip of the coracoid process and the supra-glenoid tubercle alter the shape of the subcoracoid outlet. Our objective was to measure the vertical distance between the coracoid tip and the supra-glenoid tubercle (CTGT) on MR and to assess whether this showed better correlation with rotator cuff pathology compared with the axial coraco-humeral distance.

Materials and Methods

A retrospective review was performed of 100 consecutive shoulder MR arthrograms. Vertical distance between the coracoid tip and the supraglenoid tubercle was measured in the sagittal oblique plane. Separate assessment was then made of tendon pathology of the subscapularis, supraspinatus and long head of biceps tendons. Axial coraco-humeral distance was then measured. Correlation between tendon abnormalities and the two measurements was then made.

Results

Of the 100 cases, 42 had subscapularis tendon lesions, 21 had lesions of the long head of biceps and 53 had supraspinatus tendon lesions. Mean vertical distance from the coracoid tip to supraglenoid tubercle was greater in those with lesions of any of these tendons and was statistically significant for the supraspinatus group (P = 0.005). Reduced axial coraco-humeral distance was also seen in patients with tendinopathy, although with less statistically significant difference (p = 0.059).

Conclusion

Our results support orthopaedic studies that have shown that the vertical distance between the coracoid tip and the supraglenoid tubercle increases the incidence and risk of rotator cuff disease by altering the shape of the subcoracoid outlet.
Literature
2.
go back to reference Kragh JF, Doukas WC, Basamania CJ. Primary coracoid impingement syndrome. Am J Orthop. 2004;33:229–32.PubMed Kragh JF, Doukas WC, Basamania CJ. Primary coracoid impingement syndrome. Am J Orthop. 2004;33:229–32.PubMed
3.
go back to reference Freehill MQ. Coracoid impingement: diagnosis and treatment. J Am Acad Orthop Surg. 2011;19:191–7.PubMed Freehill MQ. Coracoid impingement: diagnosis and treatment. J Am Acad Orthop Surg. 2011;19:191–7.PubMed
4.
go back to reference Giaroli EL, Major NM, Lemley DE, Lee J. Coracohumeral interval imaging in subcoracoid impingement syndrome on MRI. Am J Roentgenol. 2006;186:242–6.CrossRef Giaroli EL, Major NM, Lemley DE, Lee J. Coracohumeral interval imaging in subcoracoid impingement syndrome on MRI. Am J Roentgenol. 2006;186:242–6.CrossRef
5.
go back to reference Lo IK, Burkhart SS. The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy. 2003;19:1142–50.PubMedCrossRef Lo IK, Burkhart SS. The etiology and assessment of subscapularis tendon tears: a case for subcoracoid impingement, the roller-wringer effect, and TUFF lesions of the subscapularis. Arthroscopy. 2003;19:1142–50.PubMedCrossRef
6.
go back to reference Pfirrmann CWA, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: detection and grading at MR arthrography. Radiology. 1999;213:709–14.PubMedCrossRef Pfirrmann CWA, Zanetti M, Weishaupt D, Gerber C, Hodler J. Subscapularis tendon tears: detection and grading at MR arthrography. Radiology. 1999;213:709–14.PubMedCrossRef
7.
8.
go back to reference Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:228. Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:228.
9.
go back to reference Tuite MJ, Toivonen DA, Orwin JF, Wright DH. Acromial angle on radiographs of the shoulder: correlation with the impingement syndrome and rotator cuff tears. AJR Am J Roentgenol. 1995;165(3):609–13.PubMedCrossRef Tuite MJ, Toivonen DA, Orwin JF, Wright DH. Acromial angle on radiographs of the shoulder: correlation with the impingement syndrome and rotator cuff tears. AJR Am J Roentgenol. 1995;165(3):609–13.PubMedCrossRef
10.
go back to reference Nyffeler RW, Werner CML, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg (Am). 2006;88(4):800–5.CrossRef Nyffeler RW, Werner CML, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg (Am). 2006;88(4):800–5.CrossRef
11.
go back to reference Friedman RJ, Bonutti PM, Genez B. Cine magnetic resonance imaging of the subcoracoid region. Orthopedics. 1998;21(5):545–8.PubMed Friedman RJ, Bonutti PM, Genez B. Cine magnetic resonance imaging of the subcoracoid region. Orthopedics. 1998;21(5):545–8.PubMed
Metadata
Title
A new method for measurement of subcoracoid outlet and its relationship to rotator cuff pathology at MR arthrography
Authors
N. A. Porter
J. Singh
B. J. Tins
R. K. Lalam
P. N. M. Tyrrell
V. N. Cassar-Pullicino
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 9/2015
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-015-2166-9

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