Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Skeletal Radiology
Published in: Skeletal Radiology 11/2020

01-11-2020 | Positron Emission Tomography | Scientific Article

Muscle activities during shoulder internal rotation differ in arm position: a preliminary quantitative analysis using positron emission tomography

Authors: Gaku Matsuzawa, Hirotaka Sano, Nobuyuki Yamamoto, Daisuke Kurokawa, Shoichi Watanuki, Manabu Tashiro, Eiji Itoi

Published in: Skeletal Radiology | Issue 11/2020

Login to get access

Abstract

Objective

To investigate the muscle activity patterns of the glenohumeral joint during internal rotation both with the arm at 0° and 90° of abduction using 2-deoxy-2-[18F] fluoro-d-glucose (FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI).

Materials and methods

Six healthy male volunteers underwent PET examination after performing active glenohumeral internal rotation exercise using an elastic band both with the arm at 0° and 90° of abduction. As a control, PET scan under resting condition was also performed. The exercise was performed before and after 18 fluorodeoxyglucose injection. Each PET image was fused to the corresponding MRI to identify each muscle. The standardized uptake value (SUV) of each muscle was compared between the two arm positions.

Results

With the arm at 0° of abduction, the SUV increased significantly after exercise both in the middle and inferior 1/3 of the subscapularis, which were significantly higher than that of the superior 1/3 of the subscapularis (P < 0.05). The SUV of the inferior 1/3 of the subscapularis was significantly higher at 90° of abduction than at 0° of abduction and was significantly higher than that of the superior 1/3 at 90° of abduction (P < 0.01). The SUV after exercise in the inferior infraspinatus and teres minor increased.

Conclusions

The middle and inferior parts of the subscapularis are the main shoulder internal rotators in 0° of abduction, whereas the inferior part of the subscapularis is the main internal rotator in 90° of abduction.
Literature
1.
Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19(4):404–20.PubMed
2.
Kibler WB, Chandler TJ, Uhl T, Maddux RE. A musculoskeletal approach to the preparticipation physical examination. Preventing injury and improving performance. Am J Sports Med. 1989;17(4):525–31.PubMed
3.
Aldridge R, Stephen Guffey J, Whitehead MT, Head P. The effects of a daily stretching protocol on passive glenohumeral internal rotation in overhead throwing collegiate athletes. Int J Sports Phys Ther. 2012;7(4):365–71.PubMedPubMedCentral
4.
Awan R, Smith J, Boon AJ. Measuring shoulder internal rotation range of motion: a comparison of 3 techniques. Arch Phys Med Rehabil. 2002;83(9):1229–34.PubMed
5.
Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G. Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med. 2014;48(17):1327–33.PubMed
6.
Lintner D, Mayol M, Uzodinma O, Jones R, Labossiere D. Glenohumeral internal rotation deficits in professional pitchers enrolled in an internal rotation stretching program. Am J Sports Med. 2007;35(4):617–21.PubMed
7.
Bak K, Sørensen AK, Jørgensen U, Nygaard M, Krarup AL, Thune C, et al. The value of clinical tests in acute full-thickness tears of the supraspinatus tendon: does a subacromial lidocaine injection help in the clinical diagnosis? A prospective study. Arthroscopy. 2010;26(6):734–42.PubMed
8.
Barth JR, Burkhart SS, De Beer JF. The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy. 2006;22(10):1076–84.PubMed
9.
Decker MJ, Tokish JM, Ellis HB, Torry MR, Hawkins RJ. Subscapularis muscle activity during selected rehabilitation exercises. Am J Sports Med. 2003;31(1):126–34.PubMed
10.
Greis PE, Kuhn JE, Schultheis J, Hintermeister R, Hawkins R. Validation of the lift-off test and analysis of subscapularis activity during maximal internal rotation. Am J Sports Med. 1996;24(5):589–93.PubMed
11.
Hintermeister RA, Lange GW, Schultheis JM, Bey MJ, Hawkins RJ. Electromyographic activity and applied load during shoulder rehabilitation exercises using elastic resistance. Am J Sports Med. 1998;26(2):210–20.PubMed
12.
Itoi E, Hsu HC, An KN. Biomechanical investigation of the glenohumeral joint. J Shoulder Elb Surg. 1996;5(5):407–24.
13.
Jenp YN, Malanga GA, Growney ES, An KN. Activation of the rotator cuff in generating isometric shoulder rotation torque. Am J Sports Med. 1996;24(4):477–85.PubMed
14.
Kadaba MP, Cole A, Wootten ME, et al. Intramuscular wire electromyography of the subscapularis. J Orthop Res. 1992;10(3):394–7.PubMed
15.
Kronberg M, Németh G, Broström LA. Muscle activity and coordination in the normal shoulder. An electromyographic study. Clin Orthop Relat Res. 1990;257:76–85.
16.
Suenaga N, Minami A, Fujisawa H. Electromyographic analysis of internal rotational motion of the shoulder in various arm positions. J Shoulder Elb Surg. 2003;12(5):501–5.
17.
Chang YW, Hughes RE, Su FC, Itoi E, An KN. Prediction of muscle force involved in shoulder internal rotation. J Shoulder Elb Surg. 2000;9(3):188–95.
18.
Kuechle DK, Newman SR, Itoi E, Niebur GL, Morrey BF, An KN. The relevance of the moment arm of shoulder muscles with respect to axial rotation of the glenohumeral joint in four positions. Clin Biomech. 2000;15(5):322–9.
19.
Barden JM, Balyk R, Raso VJ, Moreau M, Bagnall K. Atypical shoulder muscle activation in multidirectional instability. Clin Neurophysiol. 2005;116(8):1846–57.PubMed
20.
Kurokawa D, Sano H, Nagamoto H, et al. Muscle activity pattern of the shoulder external rotators differs in adduction and abduction: an analysis using positron emission tomography. J Shoulder Elb Surg. 2014;23(5):658–64.
21.
Omi R, Sano H, Ohnuma M, et al. Function of the shoulder muscles during arm elevation: an assessment using positron emission tomography. J Anat. 2010;216(5):643–9.PubMedPubMedCentral
22.
Sakoma Y, Sano H, Shinozaki N, et al. Anatomical and functional segments of the deltoid muscle. J Anat. 2011;218(2):185–90.PubMed
23.
Shinozaki T, Takagishi K, Ichikawa A, et al. Use of 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) imaging for the evaluation of muscle metabolic activity in ruptured rotator cuffs: identification of shoulder muscles by fusion imaging studies involving both FDG PET and magnetic resonance imaging. J Shoulder Elb Surg. 2003;12(6):544–9.
24.
Shinozaki N, Sano H, Omi R, et al. Differences in muscle activities during shoulder elevation in patients with symptomatic and asymptomatic rotator cuff tears: analysis by positron emission tomography. J Shoulder Elb Surg. 2014;23(3):e61–7.
25.
Hughes RE, An KN. Force analysis of rotator cuff muscles. Clin Orthop Relat Res. 1996;330:75–83.
26.
Carson WG Jr. Rehabilitation of the throwing shoulder. Clin Sports Med. 1989;8(4):657–89.PubMed
27.
Defrise M, Kinahan PE, Townsend DW, Michel C, Sibomana M, Newport DF. Exact and approximate rebinning algorithms for 3-D PET data. IEEE Trans Med Imaging. 1997;16(2):145–58.PubMed
28.
Hudson HM, Larkin RS. Accelerated image reconstruction using ordered subsets of projection data. IEEE Trans Med Imaging. 1994;13(4):601–9.PubMed
29.
Ackland DC, Pandy MG. Moment arms of the shoulder muscles during axial rotation. J Orthop Res. 2011;29(5):658–67.PubMed
30.
Kubota K, Matsuzawa T, Ito M, et al. Lung tumor imaging by positron emission tomography using C-11 L-methionine. J Nucl Med. 1985;26(1):37–42.PubMed
31.
Otis JC, Jiang CC, Wickiewicz TL, Peterson MG, Warren RF, Santner TJ. Changes in the moment arms of the rotator cuff and deltoid muscles with abduction and rotation. J Bone Joint Surg Am. 1994;76(5):667–76.PubMed
32.
Ackland DC, Pandy MG. Lines of action and stabilizing potential of the shoulder musculature. J Anat. 2009;215(2):184–97.PubMedPubMedCentral
33.
Ackland DC, Pak P, Richardson M, Pandy MG. Moment arms of the muscles crossing the anatomical shoulder. J Anat. 2008;213(4):383–90.PubMedPubMedCentral
34.
Cleeman E, Brunelli M, Gothelf T, Hayes P, Flatow EL. Releases of subscapularis contracture: an anatomic and clinical study. J Shoulder Elb Surg. 2003;12(3):231–6.
35.
McCann PD, Cordasco FA, Ticker JB, et al. An anatomic study of the subscapular nerves: a guide for electromyographic analysis of the subscapularis muscle. J Shoulder Elb Surg. 1994;3(2):94–9.
36.
Yung SW, Lazarus MD, Harryman DT 2nd. Practical guidelines to safe surgery about the subscapularis. J Shoulder Elb Surg. 1996;5(6):467–70.
37.
Johnson GR, Spalding D, Nowitzke A, Bogduk N. Modelling the muscles of the scapula morphometric and coordinate data and functional implications. J Biomech. 1996;29(8):1039–51.PubMed
38.
Parsons IM, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002;20(3):439–46.PubMed
39.
Piepers I, Boudt P, Van Tongel A, De Wilde L. Evaluation of the muscle volumes of the transverse rotator cuff force couple in nonpathologic shoulders. J Shoulder Elb Surg. 2014;23(7):e158–62.
40.
Sharkey NA, Marder RA, Hanson PB. The entire rotator cuff contributes to elevation of the arm. J Orthop Res. 1994;12(5):699–708.PubMed
41.
Chao S, Thomas S, Yucha D, Kelly JD 4th, Driban J, Swanik K. An electromyographic assessment of the “bear hug”: an examination for the evaluation of the subscapularis muscle. Arthroscopy. 2008;24(11):1265–70.PubMed
42.
Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg (Br). 1991;73(3):389–94.
43.
Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am. 1996;78(7):1015–23.PubMed
44.
Hertel R, Ballmer FT, Lombert SM, Gerber C. Lag signs in the diagnosis of rotator cuff rupture. J Shoulder Elb Surg. 1996;5(4):307–13.
45.
Fujimoto T, Itoh M, Tashiro M, Yamaguchi K, Kubota K, Ohmori H. Glucose uptake by individual skeletal muscles during running using whole-body positron emission tomography. Eur J Appl Physiol. 2000;83(4–5):297–302.PubMed
46.
Ohnuma M, Sugita T, Kokubun S, Yamaguchi K, Rikimaru H. Muscle activity during a dash shown by 18F-fluorodeoxyglucose positron emission tomography. J Orthop Sci. 2006;11(1):42–5.PubMed
47.
Tashiro M, Fujimoto T, Itoh M, et al. 18F-FDG PET imaging of muscle activity in runners. J Nucl Med. 1999;40(1):70–6.PubMed
Metadata
Title
Muscle activities during shoulder internal rotation differ in arm position: a preliminary quantitative analysis using positron emission tomography
Authors
Gaku Matsuzawa
Hirotaka Sano
Nobuyuki Yamamoto
Daisuke Kurokawa
Shoichi Watanuki
Manabu Tashiro
Eiji Itoi
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 11/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-020-03490-0

Other articles of this Issue 11/2020

Skeletal Radiology 11/2020 Go to the issue

Scientific Article

Differentiating epidural fibrosis from disc herniation on contrast-enhanced and unenhanced MRI in the postoperative lumbar spine

Scientific Article

Comparison of post-operative pain scores and opioid use between kyphoplasty and radiofrequency ablation (RFA) systems combined with cement augmentation

Scientific Article

Radiographic characteristics of the hip joint in skeletally mature patients with multiple hereditary exostoses

Review Article

A comprehensive review of the normal, abnormal, and post-operative MRI appearance of the distal biceps brachii

Case Report

Concomitant calciphylaxis and COVID-19 associated thrombotic retiform purpura

Technical Report

Ultrasound-guided muscle biopsy: a practical alternative for investigation of myopathy