Effect of the acromial inferolateral tilt on subacromial impingement syndrome: a retrospective magnetic resonance imaging assessment

Vaz, André; Reifegerste, Camila Pietroski; Trippia, Cesar Rodrigo; Linhares, Lucas Savaris; Trindade, Fábio Bordin; Thomaz, José Eduardo

doi:10.1590/0100-3984.2019.0127

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Radiol Bras 53 (6) • Nov-Dec 2020 • https://doi.org/10.1590/0100-3984.2019.0127 copy

Effect of the acromial inferolateral tilt on subacromial impingement syndrome: a retrospective magnetic resonance imaging assessment

A contribuição da inclinação inferolateral do acrômio na síndrome do impacto subacromial: uma avaliação retrospectiva por ressonância magnética

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate the effect of acromial inferolateral tilt on subacromial impingement syndrome.

Materials and Methods:

The acromial inferolateral tilt was retrospectively quantified by two researchers on 346 shoulder magnetic resonance images using the glenoacromial (between the inferior proximal acromial surface and the glenoidal face) and acromioclavicular (between the axis of the proximal acromion and distal clavicle) angles.

Results:

The glenoacromial angle was associated with subacromial impingement syndrome (p < 0.001) and complete supraspinatus tendon rupture (p < 0.001), and the acromioclavicular angle was associated with partial or complete supraspinatus tendon rupture (p = 0.003). The area under the receiver operating characteristic curve (AUC), best cut-off angle, and odds ratio (OR) of the glenoacromial angle for impingement syndrome were 0.579 (95% confidence interval [CI]: 0.508-0.649; p = 0.032), 72°, and 2.1 (95% CI: 1.136-4.053), respectively. For complete supraspinatus tendon rupture, the AUC, best cut-off angle, and OR of the glenoacromial angle were 0.731 (95% CI: 0.626-0.837; p = 0.001), 69°, and 8.496 (95% CI: 2.883-28.33), respectively. For partial or complete supraspinatus tendon rupture, the AUC, best cut-off angle and OR of the acromioclavicular angle were 0.617 (95% CI: 0.539-0.694; p = 0.002), 17°, and 3.288 (95% CI: 1.886-5.768), respectively. Interobserver agreement found for the glenoacromial and acromioclavicular angles were 0.737 (95% CI: 0.676-0.787; p < 0.001) and 0.507 (95% CI: 0.391-0.601; p = 0.001), respectively.

Conclusion:

Inferolateral acromial tilt may have some impact on subacromial impingement syndrome; however, the best quantification method identified (glenoacromial angle) showed a moderate interobserver agreement and a fair performance to assess the risk of complete supraspinatus tendon rupture.

Keywords:
Shoulder impingement syndrome; Inferolateral acromial tilt; Magnetic resonance imaging

Outcome	Variable	P
Subacromial impingement syndrome	Sex	0.001 ^* * Statistically significant variables (p < 0.05).
	Age	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	0.032 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer B	0.837
	Acromioclavicular angle measured by observer A	0.306
	Acromioclavicular angle measured by observer B	0.436
Subacromial-subdeltoid bursitis	Sex	0.049 ^* * Statistically significant variables (p < 0.05).
	Age	0.091
	Glenoacromial angle measured by observer A	0.638
	Glenoacromial angle measured by observer B	0.722
	Acromioclavicular angle measured by observer A	0.685
	Acromioclavicular angle measured by observer B	0.271
Supraspinatus tendinopathy	Sex	0.005 ^* * Statistically significant variables (p < 0.05).
	Age	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	0.139
	Glenoacromial angle measured by observer B	0.939
	Acromioclavicular angle measured by observer A	0.810
	Acromioclavicular angle measured by observer B	0.804
Partial or complete supraspinatus tendon rupture	Sex	0.175
	Age	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	0.012 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer B	0.937
	Acromioclavicular angle measured by observer A	0.002 ^* * Statistically significant variables (p < 0.05).
	Acromioclavicular angle measured by observer B	0.200
Complete supraspinatus tendon rupture	Sex	0.024 ^* * Statistically significant variables (p < 0.05).
	Age	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer B	0.272
	Acromioclavicular angle measured by observer A	0.395
	Acromioclavicular angle measured by observer B	0.864

Outcome	Variable	OR	OR 95% CI	P
Subacromial impingement syndrome	Sex (male)	0.556	0.312–0.990	0.046 ^* * Statistically significant variables (p < 0.05).
	Age	1.081	1.059–1.103	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	1.029	1.016–1.043	< 0.001 ^* * Statistically significant variables (p < 0.05).
Partial or complete supraspinatus tendon rupture	Sex (male)	0.810	0.436–1.507	0.507
	Age	1.073	1.049–1.095	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	1.022	0.976–1.072	0.347
	Acromioclavicular angle measured by observer A	1.098	1.032–1.168	0.003 ^* * Statistically significant variables (p < 0.05).
Complete supraspinatus tendon rupture	Sex (male)	0.426	0.115–1.580	0.202
	Age	1.084	1.044–1.125	< 0.001 ^* * Statistically significant variables (p < 0.05).
	Glenoacromial angle measured by observer A	1.107	1.068–1.147	< 0.001 ^* * Statistically significant variables (p < 0.05).

Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Av. Paulista, 37 - 7º andar - conjunto 71, 01311-902 - São Paulo - SP, Tel.: +55 11 3372-4541, Fax: 3285-1690, Fax: +55 11 3285-1690 - São Paulo - SP - Brazil
E-mail: radiologiabrasileira@cbr.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Dr. André Vaz. Rua Bruno Filgueira, 2142, ap. 201, Bigorrilho. Curitiba, PR, Brazil, 80730-380. Email: andrevaz7@gmail.com.