Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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A Comprehensive Review of Shoulder CT Morphometry: What Surgeons Wants to Know

견관절 컴퓨터단층촬영에 대한 포괄적인 리뷰: 정형외과 의사들이 궁금해하는 것들

  • Yun, Gabin (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kang, Yusuhn (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Ahn, Joong Mo (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Lee, Eugene (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Lee, Joon Woo (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Oh, Joo Han (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital) ;
  • Kang, Heung Sik (Department of Radiology, Seoul National University Bundang Hospital)
  • 윤가빈 (분당서울대학교병원 영상의학과) ;
  • 강유선 (분당서울대학교병원 영상의학과) ;
  • 안중모 (분당서울대학교병원 영상의학과) ;
  • 이영준 (분당서울대학교병원 영상의학과) ;
  • 이준우 (분당서울대학교병원 영상의학과) ;
  • 오주한 (분당서울대학교병원 정형외과) ;
  • 강흥식 (분당서울대학교병원 영상의학과)
  • Received : 2017.01.24
  • Accepted : 2017.08.12
  • Published : 2018.04.01
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Abstract

A variety of surgical techniques have been employed for shoulder problems, i.e., arthroplasty, arthroscopy, and fracture fixation, etc. A thorough understanding and knowledge of the normal anatomy, physiology, biomechanics, and pathomechanics of the glenohumeral joint can help facilitate a successful pre-operative evaluation of the shoulder. The authors reviewed practical measurement methods of a shoulder computed tomography (CT) with three-dimensional volume-rendered images, from the orthopedic surgeon's viewpoint, to aid radiologists make structured reports. It is important that the radiologist be familiar with the normal and abnormal imaging appearances of the shoulder CT before and after the surgical procedures.

최근 견관절 수술 중 관절성형술, 관절경, 골절 후 복원 등의 빈도는 점차 많아지고 있다. 수술 전의 영상의학적 평가를 위해서는 견관절의 해부학적 구조 및 골격에 관한 이해와 관절 운동의 생리를 이해하는 것이 필수적이다. 이번 논문은 견관절 전산화단층촬영을 이용한 측정법 중 정형외과 의사가 흔히 사용하고 영상의학과 의사가 알아야 하는 여러 가지 방법에 대해 다루었다. 이를 통해 정형외과 의사들에게 유용한 소견을 효율적으로 알려줄 수 있다.

Keywords

References

  1. Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Shoulder Elbow Surg 2005;14(1 Suppl S):99S-104S https://doi.org/10.1016/j.jse.2004.09.025
  2. Whiston TB. Fractures of the surgical neck of the humerus. J Bone Joint Surg Br 1954;36-B:423-427 https://doi.org/10.1302/0301-620X.36B3.423
  3. Sandstrom CK, Kennedy SA, Gross JA. Acute shoulder trauma: what the surgeon wants to know. Radiographics 2015; 35:475-492 https://doi.org/10.1148/rg.352140113
  4. Fukuda K, Craig EV, An KN, Cofield RH, Chao EY. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 1986;68:434-440. https://doi.org/10.2106/00004623-198668030-00019
  5. Hoenecke HR Jr, Hermida JC, Flores-Hernandez C, D'Lima DD. Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty. J Shoulder Elbow Surg 2010; 19:166-171 https://doi.org/10.1016/j.jse.2009.08.009
  6. Shapiro TA, McGarry MH, Gupta R, Lee YS, Lee TQ. Biomechanical effects of glenoid retroversion in total shoulder arthroplasty. J Shoulder Elbow Surg 2007;16(3 Suppl):S90-S95 https://doi.org/10.1016/j.jse.2006.07.010
  7. Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 1992;74:1032-1037 https://doi.org/10.2106/00004623-199274070-00009
  8. Iannotti JP, Norris TR. Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis. J Bone Joint Surg Am 2003;85-A:251-258
  9. Inui H, Sugamoto K, Miyamoto T, Machida A, Hashimoto J, Nobuhara K. Evaluation of three-dimensional glenoid structure using MRI. J Anat 2001;199(Pt 3):323-328 https://doi.org/10.1017/S002187820100810X
  10. Matsumura N, Ogawa K, Ikegami H, Collin P, Walch G, Toyama Y. Computed tomography measurement of glenoid vault version as an alternative measuring method for glenoid version. J Orthop Surg Res 2014;9:17 https://doi.org/10.1186/1749-799X-9-17
  11. Farron A, Terrier A, Buchler P. Risks of loosening of a prosthetic glenoid implanted in retroversion. J Shoulder Elbow Surg 2006;15:521-526 https://doi.org/10.1016/j.jse.2005.10.003
  12. Walch G, Badet R, Boulahia A, Khoury A. Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplasty 1999;14:756-760 https://doi.org/10.1016/S0883-5403(99)90232-2
  13. Boileau P, Bicknell RT, Mazzoleni N, Walch G, Urien JP. CT scan method accurately assesses humeral head retroversion. Clin Orthop Relat Res 2008;466:661-669 https://doi.org/10.1007/s11999-007-0089-z
  14. Kronberg M, Brostrom LA. Humeral head retroversion in patients with unstable humeroscapular joints. Clin Orthop Relat Res 1990;260:207-211
  15. Boileau P, Walch G, Liotard JP. [Radio-cinematographic study of active elevation of the prosthetic shoulder]. Rev Chir Orthop Reparatrice Appar Mot 1992;78:355-364
  16. Robertson DD, Yuan J, Bigliani LU, Flatow EL, Yamaguchi K. Three-dimensional analysis of the proximal part of the humerus: relevance to arthroplasty. J Bone Joint Surg Am 2000; 82-A:1594-1602
  17. Hempfing A, Leunig M, Ballmer FT, Hertel R. Surgical landmarks to determine humeral head retrotorsion for hemiarthroplasty in fractures. J Shoulder Elbow Surg 2001;10:460-463 https://doi.org/10.1067/mse.2001.117127
  18. Kummer FJ, Perkins R, Zuckerman JD. The use of the bicipital groove for alignment of the humeral stem in shoulder arthroplasty. J Shoulder Elbow Surg 1998;7:144-146 https://doi.org/10.1016/S1058-2746(98)90225-7
  19. Hertel R, Knothe U, Ballmer FT. Geometry of the proximal humerus and implications for prosthetic design. J Shoulder Elbow Surg 2002;11:331-338 https://doi.org/10.1067/mse.2002.124429
  20. McPherson EJ, Friedman RJ, An YH, Chokesi R, Dooley RL. Anthropometric study of normal glenohumeral relationships. J Shoulder Elbow Surg 1997;6:105-112 https://doi.org/10.1016/S1058-2746(97)90030-6
  21. Krahl VE. The phylogeny and ontogeny of humeral torsion. Am J Phys Anthropol 1976;45(3 pt. 2):595-599 https://doi.org/10.1002/ajpa.1330450325
  22. Saka M, Yamauchi H, Yoshioka T, Hamada H, Gamada K. Conventional humeral retroversion measurements using computed tomography slices or ultrasound images are not correlated with the 3-dimensional humeral retroversion angle. Orthop J Sports Med 2015;3:2325967115573701
  23. Saka M, Yamauchi H, Hoshi K, Yoshioka T, Hamada H, Gamada K. Reliability and validity in measurement of true humeral retroversion by a three-dimensional cylinder fitting method. J Shoulder Elbow Surg 2015;24:809-813 https://doi.org/10.1016/j.jse.2014.09.041
  24. Boileau P, Villalba M, Hery JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 2006;88:1755-1763 https://doi.org/10.2106/JBJS.E.00817
  25. Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. Am J Sports Med 1997;25:306-311 https://doi.org/10.1177/036354659702500306
  26. Stevens KJ, Preston BJ, Wallace WA, Kerslake RW. CT imaging and three-dimensional reconstructions of shoulders with anterior glenohumeral instability. Clin Anat 1999;12:326-336 https://doi.org/10.1002/(SICI)1098-2353(1999)12:5<326::AID-CA3>3.0.CO;2-W
  27. Itoi E, Lee SB, Amrami KK, Wenger DE, An KN. Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 2003;31:112-118 https://doi.org/10.1177/03635465030310010301
  28. Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 2000;82:35-46 https://doi.org/10.2106/00004623-200001000-00005
  29. Saliken DJ, Bornes TD, Bouliane MJ, Sheps DM, Beaupre LA. Imaging methods for quantifying glenoid and Hill-Sachs bone loss in traumatic instability of the shoulder: a scoping review. BMC Musculoskelet Disord 2015;16:164 https://doi.org/10.1186/s12891-015-0607-1
  30. Burkhart SS, Debeer JF, Tehrany AM, Parten PM. Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 2002;18:488-491 https://doi.org/10.1053/jars.2002.32212
  31. Chuang TY, Adams CR, Burkhart SS. Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 2008;24: 376-382 https://doi.org/10.1016/j.arthro.2007.10.008
  32. Sugaya H. Techniques to evaluate glenoid bone loss. Curr Rev Musculoskelet Med 2014;7:1-5 https://doi.org/10.1007/s12178-013-9198-3
  33. Bois AJ, Fening SD, Polster J, Jones MH, Miniaci A. Quantifying glenoid bone loss in anterior shoulder instability: reliability and accuracy of 2-dimensional and 3-dimensional computed tomography measurement techniques. Am J Sports Med 2012;40:2569-2577 https://doi.org/10.1177/0363546512458247
  34. Nofsinger C, Browning B, Burkhart SS, Pedowitz RA. Objective preoperative measurement of anterior glenoid bone loss: a pilot study of a computer-based method using unilateral 3-dimensional computed tomography. Arthroscopy 2011;27:322-329 https://doi.org/10.1016/j.arthro.2010.09.007
  35. Assuncao JH, Gracitelli ME, Borgo GD, Malavolta EA, Bordalo-Rodrigues M, Ferreira Neto AA. Tomographic evaluation of Hill-Sachs lesions: is there a correlation between different methods of measurement? Acta Radiol 2017;58:77-83 https://doi.org/10.1177/0284185116633918
  36. Richards RD, Sartoris DJ, Pathria MN, Resnick D. Hill-Sachs lesion and normal humeral groove: MR imaging features allowing their differentiation. Radiology 1994;190:665-668 https://doi.org/10.1148/radiology.190.3.8115607
  37. Kodali P, Jones MH, Polster J, Miniaci A, Fening SD. Accuracy of measurement of Hill-Sachs lesions with computed tomography. J Shoulder Elbow Surg 2011;20:1328-1334 https://doi.org/10.1016/j.jse.2011.01.030
  38. Cho SH, Cho NS, Rhee YG. Preoperative analysis of the Hill-Sachs lesion in anterior shoulder instability: how to predict engagement of the lesion. Am J Sports Med 2011;39:2389-2395 https://doi.org/10.1177/0363546511398644
  39. Kaar SG, Fening SD, Jones MH, Colbrunn RW, Miniaci A. Effect of humeral head defect size on glenohumeral stability: a cadaveric study of simulated Hill-Sachs defects. Am J Sports Med 2010;38:594-599 https://doi.org/10.1177/0363546509350295
  40. Provencher MT, Frank RM, Leclere LE, Metzger PD, Ryu JJ, Bernhardson A, et al. The Hill-Sachs lesion: diagnosis, classification, and management. J Am Acad Orthop Surg 2012; 20:242-252 https://doi.org/10.5435/JAAOS-20-04-242
  41. Yun G, Kang Y, Ahn JM, Lee E, Lee JW, Oh JH, et al. Posterior decentering of the humeral head on shoulder MR arthrography: significant association with posterior synovial proliferation. AJR Am J Roentgenol 2017;208:1297-1303 https://doi.org/10.2214/AJR.16.17198
  42. Shah N, Tung GA. Imaging signs of posterior glenohumeral instability. AJR Am J Roentgenol 2009;192:730-735 https://doi.org/10.2214/AJR.07.3849
  43. Tung GA, Hou DD. MR arthrography of the posterior labrocapsular complex: relationship with glenohumeral joint alignment and clinical posterior instability. AJR Am J Roentgenol 2003;180:369-375 https://doi.org/10.2214/ajr.180.2.1800369
  44. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006;37:691-697 https://doi.org/10.1016/j.injury.2006.04.130
  45. Neer CS 2nd. Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am 1970;52:1090-1103 https://doi.org/10.2106/00004623-197052060-00002
  46. Murray IR, Amin AK, White TO, Robinson CM. Proximal humeral fractures. J Bone Joint Surg Br 2011;93-B:1-11 https://doi.org/10.1302/0301-620X.93B1.25702
  47. Sidor ML, Zuckerman JD, Lyon T, Koval K, Cuomo F, Schoenberg N. The Neer classification system for proximal humeral fractures. An assessment of interobserver reliability and intraobserver reproducibility. J Bone Joint Surg Am 1993;75: 1745-1750 https://doi.org/10.2106/00004623-199312000-00002
  48. Siebenrock KA, Gerber C. The reproducibility of classification of fractures of the proximal end of the humerus. J Bone Joint Surg Am 1993;75:1751-1755 https://doi.org/10.2106/00004623-199312000-00003
  49. Berkes MB, Dines JS, Little MT, Garner MR, Shifflett GD, Lazaro LE, et al. The impact of three-dimensional CT imaging on intraobserver and interobserver reliability of proximal humeral fracture classifications and treatment recommendations. J Bone Joint Surg Am 2014;96:1281-1286 https://doi.org/10.2106/JBJS.M.00199
  50. Cho CH, Oh JH, Jung GH, Moon GH, Rhyou IH, Yoon JP, et al. The interrater and intrarater agreement of a modified neer classification system and associated treatment choice for lateral clavicle fractures. Am J Sports Med 2015;43:2431-2436 https://doi.org/10.1177/0363546515593949
  51. Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg 2004;13:427-433 https://doi.org/10.1016/j.jse.2004.01.034
  52. Min W, Davidovitch RI, Tejwani NC. Three-and four-part proximal humerus fractures: evolution to operative care. Bull NYU Hosp Jt Dis 2012;70:25-34
  53. Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 2007;35:316-329 https://doi.org/10.1177/0363546506298022
  54. Williams GR, Nguyen VD, Rockwood CA. Classification and radiographic analysis of acromioclavicular dislocations. Appl Radiol 1989;18:29-34
  55. Senna LF, Pires E Albuquerque R. Modified axillary radiograph of the shoulder: a new position. Rev Bras Ortop 2016; 52:115-118

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