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Türk Popülasyonunda Akromion Morfolojisinin Subakromial İmpingement ve Rotator Manşet Yırtıkları ile İlişkisi

Yıl 2019, Cilt: 29 Sayı: 3, 119 - 123, 01.09.2019

Kutsi Tuncer Gökhan Polat

Öz

Amaç: Akromion tipleri ve os akromiale varlığının subakromial impingement ve rotator manşet yırtıkları ile ilişkisini manyetik rezonans görüntüleme aracılığıyla incelemeyi amaçladık.Gereç ve Yöntem: 18-85 yaş arasında omuz MR çekimi olan hastalar n=573 çalışmaya dahil edildi ve cerrahi öyküsü bulunan hastalar n=34 , travma öyküsü ve fraktürü olanlar n=23 çalışamadan çıkarıldı. 516 hastanın 516 omuz MR çekiminde os akromiale varlığı ve akromion tipleri belirlendi. Supraspinatus kasında impingement bulgusu olarak proton ağırlıklı görüntülerde hiperintens sinyal artımı ve yırtıkları değerlendirildi. Os akromiale varlığı ve akromion tipleri, supraspinatus sinyal artımı ve yırtıkları her hasta için aynı radyolog tarafından belirlendi.Bulgular: Supraspinatus tendonundada sinyal artışı olanlarda os akromiale %4 görülürken, sinyal artışı olmayanlarda %0.008 görüldü. Supraspinatus tendonunda yırtığı olanlarda os akromiale %0.06 görülürken, yırtığı olmayanlarda %0.02 görüldü. Os akromiale ile supraspinatus yırtığı arasında anlamlı ilişki izlenmedi p=0.055 . Os akromiale ile supraspinatus sinyali arasında ise anlamlı ilişki mevcuttu p=0.043 . Akromion tiplerinden Tip I ve Tip III ile supraspinatus sinyal artışı arasında anlamlı ilişki mevcuttu sırasıyla; p=0.028, p=0.029 . Ayrıca, Tip I ve Tip III akromionun supraspinatus tendonu yırtığı ile de anlamlı ilişkisi mevcuttu sırasıyla; p=0.009, p=0.0061 .Sonuç: Tip I ve Tip III akromion subakromial impingement sendromu ve supraspinatus tendon yırtığı açısından risk oluşturmaktadır. Os akromiale varlığıda impingement açısından risk oluşturan bir anatomik varyasyondur

Anahtar Kelimeler

Akromion İmpingement Rotator manşet Omuz MRG

Kaynakça

  • El-Din WAN, Ali MHM. A Morphometric Study of the Pat- terns and Variations of the Acromion and Glenoid Cavity of the Scapulae in Egyptian Population. J Clin Diagn Res 2015;9:Ac8-Ac11.
  • Neer CS, 2nd. Anterior acromioplasty for the chronic im- pingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972;54:41-50.
  • Balke M, Schmidt C, Dedy N, et al. Correlation of acromial morphology with impingement syndrome and rotator cuff tears. Acta Orthop 2013;84:178-83.
  • Gumina S, De Santis P, Salvatore M, Postacchini F. Relati- onship between os acromiale and acromioclavicular joint anatomic position. J Shoulder Elb Surg 2003;12:6-8.
  • Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg 1996;5:1-11.
  • Bigliani BUME AE. The morphology of the acromion and its relationshipto rotator cuff tears. Orthop Trans 1986;10:216.
  • Vanarthos WJ, Monu JU. Type 4 acromion: a new classifica- tion. Contemp Orthop 1995;30:227-9.
  • Aragao JA, Silva LP, Reis FP, Dos Santos Menezes CS. Analy- sis on the acromial curvature and its relationships with the subacromial space and types of acromion. Rev Bras Ortop 2014;49:636-41.
  • Spencer EE, Jr. Dunn WR, Wright RW, et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sports Med 2008;36:99- 103.
  • Toivonen DA, Tuite MJ, Orwin JF. Acromial structure and tears of the rotator cuff. J Shoulder Elbow Surg 1995;4:376- 83.
  • Natsis K, Tsikaras P, Totlis T, et al. Correlation between the four types of acromion and the existence of enthesophytes: A study on 423 dried scapulas and review of the literature. Clin Anat 2007;20:267-72.
  • Kumar J, Park WH, Kim SH, Lee HI, Yoo JC. The preva- lence of os acromiale in Korean patients visiting shoulder clinic. Clin Orthop Surg 2013;5:202-8.
  • Wang JC1, Hatch JD, Shapiro MS.Comparison of MRI and radiographs in the evaluation of acromial morphology. Ort- hopedics 2000;23:1269-71.
  • Coskun N, Karaali K, Cevikol C, Demirel BM, Sindel M. Anatomical basics and variations of the scapula in Turkish adults. Saudi Med J 2006;27:1320-5.
  • Hirano M, Ide J, Takagi K. Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluati- on. J Shoulder Elbow Surg 2002;11:576-8.
  • Kum DH, Kim JH, Park KM, et al. Acromion Index in Ko- rean Population and Its Relationship with Rotator Cuff Te- ars. Clin Orthop Surg 2017;9:218-22.
  • Rovesta C, Marongiu MC, Corradini A, Torricelli P, Liga- bue G. Os acromiale: frequency and a review of 726 shoul- der MRI. Musculoskelet Surg 2017;101:201-5.
  • Boehm TD, Rolf O, Martetschlaeger F, Kenn W, Gohlke F. Rotator cuff tears associated with os acromiale. Acta Ort- hop 2005;76:241-4.

Yıl 2019, Cilt: 29 Sayı: 3, 119 - 123, 01.09.2019

Kutsi Tuncer Gökhan Polat

Öz

Objective: We aimed to investigate the association of acromion types and os acromiale presence with subacromial impingement and rotator cuff ruptures by Magnetic Resonance Imaging.Material and Methods: Patients with shoulder MR images between 18-85 years of age n = 573 were included in the study, and patients with a history of surgery n = 34 , trauma history and fracture n = 23 were excluded from the study. 516 patients with 516 shoulder MR images, the presence of os acromiale and acromion types were determined. In supraspinatus muscle, hyperintense increased signaland tears in proton weighted images were evaluated as signs of impingement. The presence of os acromiale and acromion types, supraspinatus increased signaland tears were determined by the same radiologist for each patient.Results: In patients with increased signal in supraspinatus, os acromiale was 4%.os acromiale was seen in 0.008% of the patients without signal enhancement.In supraspinatus tears, os acromiale was seen in 0.06%. Os acromiale was seen in 0.02%of the patients without supraspinatus tears. There was no significant correlation between os acromiale and supraspinatus tears p = 0.055 .There was a significant correlation between os acromiale and supraspinatus signal p = 0.043 .There was a significant correlation between acromion types in Type I and Type III in terms of supraspinatus signal increase p = 0.028, p = 0.029, respectively .In addition, Type I and Type III acromion were significantly associated with supraspinatus tendon tears p = 0.009, p = 0.0061, respectively .Conclusion: Type I and Type III acromion are significant in terms of subacromial impingement syndrome and supraspinatus tendon tears. Os acromiale is an anatomic variation that poses a risk for subacromial impingement

Anahtar Kelimeler

Acromion Impingement Rotator cuff Sholder MRI

Kaynakça

  • El-Din WAN, Ali MHM. A Morphometric Study of the Pat- terns and Variations of the Acromion and Glenoid Cavity of the Scapulae in Egyptian Population. J Clin Diagn Res 2015;9:Ac8-Ac11.
  • Neer CS, 2nd. Anterior acromioplasty for the chronic im- pingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972;54:41-50.
  • Balke M, Schmidt C, Dedy N, et al. Correlation of acromial morphology with impingement syndrome and rotator cuff tears. Acta Orthop 2013;84:178-83.
  • Gumina S, De Santis P, Salvatore M, Postacchini F. Relati- onship between os acromiale and acromioclavicular joint anatomic position. J Shoulder Elb Surg 2003;12:6-8.
  • Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg 1996;5:1-11.
  • Bigliani BUME AE. The morphology of the acromion and its relationshipto rotator cuff tears. Orthop Trans 1986;10:216.
  • Vanarthos WJ, Monu JU. Type 4 acromion: a new classifica- tion. Contemp Orthop 1995;30:227-9.
  • Aragao JA, Silva LP, Reis FP, Dos Santos Menezes CS. Analy- sis on the acromial curvature and its relationships with the subacromial space and types of acromion. Rev Bras Ortop 2014;49:636-41.
  • Spencer EE, Jr. Dunn WR, Wright RW, et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sports Med 2008;36:99- 103.
  • Toivonen DA, Tuite MJ, Orwin JF. Acromial structure and tears of the rotator cuff. J Shoulder Elbow Surg 1995;4:376- 83.
  • Natsis K, Tsikaras P, Totlis T, et al. Correlation between the four types of acromion and the existence of enthesophytes: A study on 423 dried scapulas and review of the literature. Clin Anat 2007;20:267-72.
  • Kumar J, Park WH, Kim SH, Lee HI, Yoo JC. The preva- lence of os acromiale in Korean patients visiting shoulder clinic. Clin Orthop Surg 2013;5:202-8.
  • Wang JC1, Hatch JD, Shapiro MS.Comparison of MRI and radiographs in the evaluation of acromial morphology. Ort- hopedics 2000;23:1269-71.
  • Coskun N, Karaali K, Cevikol C, Demirel BM, Sindel M. Anatomical basics and variations of the scapula in Turkish adults. Saudi Med J 2006;27:1320-5.
  • Hirano M, Ide J, Takagi K. Acromial shapes and extension of rotator cuff tears: magnetic resonance imaging evaluati- on. J Shoulder Elbow Surg 2002;11:576-8.
  • Kum DH, Kim JH, Park KM, et al. Acromion Index in Ko- rean Population and Its Relationship with Rotator Cuff Te- ars. Clin Orthop Surg 2017;9:218-22.
  • Rovesta C, Marongiu MC, Corradini A, Torricelli P, Liga- bue G. Os acromiale: frequency and a review of 726 shoul- der MRI. Musculoskelet Surg 2017;101:201-5.
  • Boehm TD, Rolf O, Martetschlaeger F, Kenn W, Gohlke F. Rotator cuff tears associated with os acromiale. Acta Ort- hop 2005;76:241-4.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Article
Yazarlar

Kutsi Tuncer Bu kişi benim

Gökhan Polat Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 29 Sayı: 3

Kaynak Göster

Vancouver Tuncer K, Polat G. Türk Popülasyonunda Akromion Morfolojisinin Subakromial İmpingement ve Rotator Manşet Yırtıkları ile İlişkisi. Genel Tıp Derg. 2019;29(3):119-23.

Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.