The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Evaluation of the cross-sectional area of acromion process for shoulder impingement syndrome

  • Joo, Young (Department of Anesthesiology and Pain Medicine, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine) ;
  • Cho, Hyung Rae (Department of Anesthesiology and Pain Medicine, Myongji Hospital, Hanyang University College of Medicine) ;
  • Kim, Young Uk (Department of Anesthesiology and Pain Medicine, Catholic Kwandong University International St. Mary's Hospital, Catholic Kwandong University College of Medicine)
  • Received : 2019.07.09
  • Accepted : 2019.09.16
  • Published : 2020.01.01
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Abstract

Background: Anatomic changes in the acromion have been considered a main cause of shoulder impingement syndrome (SIS). To evaluate the relationship between SIS and the acromion process, we devised a new morphological parameter called the acromion process cross-sectional area (APA). We hypothesized that the APA could be an important morphologic diagnostic parameter in SIS. Methods: We collected APA data from 95 patients with SIS and 126 control subjects who underwent shoulder magnetic resonance imaging (MRI). Then we measured the maximal cross-sectional area of the bone margin of the acromion process on MRI scans. Results: The mean of APAs were 136.50 ± 21.75 ㎟ in the male control group and 202.91 ± 31.78 ㎟ in the male SIS group; SIS patients had significantly greater APAs (P < 0.001). The average of APAs were 105.38 ± 19.07 ㎟ in the female control group and 147.62 ± 22.90 ㎟ in the female SIS group, and the SIS patients had significantly greater APAs (P < 0.001). The optimal APA cut-off in the male group was 165.14 ㎟ with 90.2% sensitivity, 91.4% specificity, and an area under the curve (AUC) of 0.968. In the female group, the optimal cut-off was 122.50 ㎟ with 85.2% sensitivity, 84.9% specificity, and an AUC of 0.928. Conclusions: The newly devised APA is a sensitive parameter for assessing SIS; greater APA is associated with a higher possibility of SIS. We think that this result will be helpful for the diagnosis of SIS.

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References

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