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European Radiology
Published in: European Radiology 1/2015

01-01-2015 | Musculoskeletal

Is the lateral extension of the acromion related to the outcome of shoulder injections?

Authors: Tobias Johannes Dietrich, Beat K. Moor, Gabor J. Puskas, Christian W. A. Pfirrmann, Juerg Hodler, Cynthia K. Peterson

Published in: European Radiology | Issue 1/2015

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Abstract

Objective

To assess patients’ outcomes after subacromial or glenohumeral injections based on the degree of lateral extension of the acromion.

Methods

307 patients were prospectively included after therapeutic fluoroscopy-guided subacromial (n = 148) or glenohumeral (n = 159) injections with anaesthetic and long-acting corticosteroids. Pre- and post-injection outcomes at 1 week and 1 month were obtained using the 11-point numerical rating scale (NRS) for pain. Lateral extension of the acromion was quantified and categorized by the critical shoulder angle (CSA) and the acromion index (AI) on anteroposterior conventional radiographs.

Results

Patients’ outcomes at 1 week and 1 month were significantly improved (p < 0.001) compared to baseline for subacromial and glenohumeral injection patients. Patients with a CSA <35° showed significantly higher pain reduction 1 month after subacromial injection compared to patients with a CSA >35° (4.2 ± 2.6 vs. 3.2 ± 3.0, p = 0.04). A significant difference in the 1-month NRS change in pain scores is noted for smaller AIs after subacromial injection (4.3 ± 2.8 vs. 2.6 ± 2.9; p = 0.01). No significant association was noted between clinical outcome and the lateral extension of the acromion after glenohumeral joint injections.

Conclusions

A short lateral extension of the acromion was associated with better clinical outcomes in subacromial injection patients but not in glenohumeral injection patients.

Key Points

• Patients’ outcomes at 1 month improved significantly compared to baseline for subacromial injections
•Patients’ outcomes at 1 month improved significantly compared to baseline for glenohumeral injections
•Short acromial lateralization was associated with better clinical outcome after subacromial injection
•The acromial lateralization was not associated with clinical outcome after glenohumeral injection
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Metadata
Title
Is the lateral extension of the acromion related to the outcome of shoulder injections?
Authors
Tobias Johannes Dietrich
Beat K. Moor
Gabor J. Puskas
Christian W. A. Pfirrmann
Juerg Hodler
Cynthia K. Peterson
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3403-7

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