Assesment of Coracoid Inclination Angle and Coracoacromial Arch Angle on MRI in Rotator Cuff Tears

Year 2019, , 167 - 172, 31.08.2019

Neşe Asal

https://doi.org/10.24938/kutfd.532981

Abstract

Objective: The purpose of this study was to
investigate the role of the coracoid inclination angle and the coracoacromial
arch angle in the etiology of rotator cuff tears on magnetic resonance imaging.

Material and Methods: A total of 102 shoulder magnetic
resonance imaging taken in our clinic between January 2014 and January 2019
were retrospectively evaluated. Supraspinatus tendon was evaluated for partial
tear and full tear. The coracoid inclination angle and the coracoacromial arch
angle were measured in all cases. Independent t test was used for comparisons
between groups. Pearson correlation analysis was performed between the coracoid
inclination angle and the coracoacromial arch angle.

Results: There were 29 female and 24 male
patients in the rotator cuff tear group and the mean age was 49.5±11.3 years.
There were 21 female and 28 male patients in the control group and the mean age
was 45.08±11.7 years. In the rotator cuff tear group; the mean coracoid
inclination angle was 92.8±8º and the mean coracoacromial arch angle was
127.4±7.3º. In the control group; the mean coracoid inclination angle was
106.5±9.5º and the mean coracoacromial arch angle was 122.4±5º. A statistically
significant difference was found between the groups for both angle values (p
<0.05).

Conclusion: The coracoid inclination angle was
narrower and the coracoacromial arch angle was wider in rotator cuff tear
cases. Coracoid process morphology and related variable coracoid inclination
angle, coracoacromial arch angle may be the predisposing factors for rotator
cuff tears and may be used to help determine the etiology of rotator cuff
pathologies.

Keywords

Coracoid, impingement syndrome, magnetic resonance imaging, rotator cuff

ROTATOR MANŞET YIRTIKLARINDA MRG İLE KORAKOİD İNKLİNASYON AÇISI VE KORAKOAKROMİAL ARK AÇISININ DEĞERLENDİRİLMESİ

Abstract

Amaç: Bu çalışmada, rotator manşet
yırtıklarının etyolojisinde korakoid inklinasyon açısı ve korakoakromial ark
açısının rolünün manyetik rezonans görüntüleme ile araştırılması amaçlandı.

Gereç ve Yöntemler:
Çalışmada
Ocak 2014-Ocak 2019 tarihleri arası kliniğimizde çekilmiş total 102 omuz manyetik rezonans görüntüleme retrospektif olarak değerlendirildi.
Supraspinatus tendonu, parsiyel yırtık ve tam kat yırtık açısından
değerlendirildi. Tüm olgularda korakoid inklinasyon açısı ve korakoakromial ark
açısı ölçümü yapıldı. Gruplar arasındaki karşılaştırmalar için independent t
testi kullanıldı. Ayrıca korakoid inklinasyon açı ve korakoakromial ark açısı
arasında Pearson korelasyon analizi yapıldı.

Bulgular: Rotator manşet yırtık olan grupta 29
kadın, 24 erkek olup yaş ortalaması 49.5±11.3 yıl; kontrol grubunda 21 kadın,
28 erkek olup yaş ortalaması 45.08±11.7 yıldı. Rotator manşet yırtık olan
grupta; korakoid inklinasyon açı ortalaması 92.8±8º, korakoakromial ark açı
ortalaması 127.4±7.3º idi. Kontrol grubunda; korakoid inklinasyon açı
ortalaması 106.5±9.5º, korakoakromial ark açı ortalaması 122.4±5º idi. Gruplar
arasında her iki açı değeri için istatistiksel anlamlı farklılık tespit edildi
(p <0.05).

Sonuç: Rotator manşet
yırtık olgularında, korakoid inklinasyon açısı daha dar ve korako-akromial ark
açısı daha genişti. Korakoid proçes morfolojisi ve buna bağlı değişken korakoid
inklinasyon açısı, korakoakromial ark açısı rotator manşet yırtıkları için
predispozan faktörler olabilir, rotator manşet patolojilerinin etyolojisini
belirlemede yardımcı olarak kullanılabilir.

Keywords

korakoid, impingement sendromu, manyetik rezonans görüntüleme, rotator manşet

References

• 1. Bodo K, Abbas M, Temperley D, Midgley A, Monga P. A Novel MRI Measurement for Analysing Coracoacromial Morphology. Int J Orthopaedics. 2018;5(1):883-890.
• 2. Cay N, Tosun O, Isik C, Unal O, Kartal MG, Bozkurt M. Is coracoacromial arch angle a predisposing factor for rotator cuff tears? Diagn Interv Radiol. 2014;20(6):498-502.
• 3. Balke M, Liem D, Greshake O, Hoeher J, Bouillon B, Banerjee M. Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24(7):2200-5.
• 4. Torrens C, Alentorn-Geli E, Sanchez JF, Isart A, Santana F. Decreased axial coracoid inclination angle is associated with rotator cuff tears. J Orthop Surg (Hong Kong).2017;25(1):2309499017690329.
• 5. Okoro T, Reddy V, Pimpelnarkar A. Coracoid impingement syndrome: a literature review. Curr Rev Musculoskelet Med. 2009;2(1):51-5.
• 6. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder. 1972. J Bone Joint Surg Am. 2005;87(6):1399.
• 7. Codman EA, Akerson IB. The pathology associated with rupture of the supraspinatus tendon. Ann Surg. 1931;93(1):348-59.
• 8. Balke M, Liem D, Greshake O, Hoeher J, Bouillon B, Banerjee M. Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2200-5.
• 9. Bigliani L, Morrison D, April E. The morphology of the acromion and rotator cuff impingement. Orthop Trans. 1986;10:228.
• 10. Edelson J, Taitz C. Anatomy of the coraco-acromial arch. Relation to degeneration of the acromion. J Bone Joint Surg British volume. 1992;74(4):589-94.
• 11. Sakoma Y, Sano H, Shinozaki N, Itoigawa Y, Yamamoto N, Itoi E. Coverage of the humeral head by the coracoacromial arch: relationship with rotator cuff tears. Acta Medica Okayama. 2013;67(6):377-83.
• 12. Cetinkaya M, Ataoglu MB, Ozer M, Ayanoglu T, Kanatli U. Subscapularis tendon slip number and coracoid overlap are more related parameters for subcoracoid impingement in subscapularis tears: a magnetic resonance imaging comparison study. Arthroscopy. 2017;33(4):734-42.
• 13. Dugarte AJ, Davis RJ, Lynch TS, Schickendantz MS, Farrow LD. Anatomic Study of Subcoracoid Morphology in 418 Shoulders: Potential Implications for Subcoracoid Impingement. Orthop J Sports Med. 2017;5(10):2325967117731996.
• 14. Osti L, Soldati F, Del Buono A, Massari L. Subcoracoid impingement and subscapularis tendon: is there any truth? Muscles Ligaments Tendons J. 2013;3(2):101.
• 15. McBain L, Simonds E, Iwanaga J, Tubbs RS. Review of the pathology and congenital anomalies of the coracoid process with clinical applications. Translational Research in Anatomy. 2018;10:4-6.
• 16. Kesmezacar H, Akgun I, Ogut T, Gokay S, Uzun I. The coracoacromial ligament: the morphology and relation to rotator cuff pathology. J Shoulder Elbow Surg. 2008;17(1):182-8.
• 17. Kanatli U, Ayanoglu T, Aktas E, Ataoglu MB, Ozer M, Cetinkaya M. Grade of coracoacromial ligament degeneration as a predictive factor for impingement syndrome and type of partial rotator cuff tear. J Shoulder Elbow Surg. 2016;25(11):1824-8.
• 18. Watson AC, Jamieson RP, Mattin AC, Page RS. Magnetic resonance imaging based coracoid morphology and its associations with subscapularis tears: a new index. Shoulder Elbow. 2019;11(1 Suppl):52-58. Doi:10.1177/1758573217744170. (Epub 2017 Dec 11).
• 19. Yamamoto N, Muraki T, Sperling JW, Steinmann SP, Itoi E, Cofield RH et al. Contact between the coracoacromial arch and the rotator cuff tendons in nonpathologic situations: a cadaveric study. J Shoulder Elbow Surg. 2010;19(5):681-7.
• 20. Brunkhorst JP, Giphart JE, LaPrade RF, Millett PJ. Coracohumeral distances and correlation to arm rotation: an in vivo 3-dimensional biplane fluoroscopy study. Orthop J Sports Med. 2013;1(2):2325967113496059.