Subkorakoid sıkışmada, korakoid morfolojisinin, korakohumeral mesafenin, korakoglenoid açının ve korakohumeral açının MRG ile değerlendirilmesi

Year 2021, Volume: 5 Issue: 2, 97 - 102, 25.06.2021

Veysel Kaplanoğlu , Hatice Kaplanoğlu

https://doi.org/10.33716/bmedj.852552

Abstract

Amaç: Bu çalışmanın amacı, korakoid morfolojisi, korakohumeral mesafe,korakoglenoid açı ve korakohumeral açı değişkenlerinin subkorakoid sıkışma gelişimi üzerine etkileri manyetik rezonans (MRG) ile değerlendirilmektir. Gereç ve Yöntem: Retrospektif çalışmaya omuz MRG çekilen toplam 255 hasta (ort. yaş 51.25±15.77 olan 115 erkek ve ort.yaş 53.13±14.75 olan 140 kadın) alındı. MRG incelemeleri standart pozisyonda yapıldı. Korakoid morfolojisi ve subskapularis tendonu değerlendirildi. Tüm olgularda korakohumeral mesafe, korakoglenoid açı ve korakohumeral açı ölçüldü. Gruplar arasındaki farkı değerlendirmek için tek yönlü ANOVA kullanıldı. İkili karşılaştırmalar için, Tukey post hoc analizi yapıldı. Değişkenler arasında Pearson korelasyon analizi yapıldı. Bulgular: Subskapularis tendonu yırtık olan grupta en sık Tip C korakoid görüldü. Korakohumeral mesafe, korakoglenoid açı ve korakohumeral açı değerleri için korakoid tipleri arasında istatistiksel olarak anlamlı bir fark saptanmadı (p> 0.05). Subskapularis tendon yırtığı olan hastalarda korakoglenoid açı değerlerinde ve korakohumeral mesafede istatistiksel olarak anlamlı bir azalma vardı (p= 0.000). Korakohumeral açı değeri için tendonu normal olanlar, tendinozis olanlar ve yırtık olan grupların ortalamaları arasında fark yoktu (p>0.05). Korakohumeral mesafe ile korakoglenoid açı arasında pozitif yönlü korelasyon bulundu (r=0.239, p<0.001). Korakoglenoid açı ile korakohumeral açı arasında negatif yönlü korelasyon bulundu (r=-0.320 , p<0.001). Sonuç: Subskapularis tendon patolojilerinde korakohumeral mesafe ve korakoglenoid açıda azalma gözlendi. Tip C korakoid subkorakoid sıkışmada etkili ve önemli bir faktördür.

Keywords

Manyetik Rezonans Görüntüleme, Subskapular tendon, Subkorakoid sıkışma, Korakois proses

MRI evaluation of coracoid morphology, coracohumeral distance, coracoglenoid angle and coracohumeral angle in subcoracoid impingement

Abstract

Aim: This study aimed to evaluate the effects of coracoid morphology, coracohumeral distance,coracoglenoid angle, and coracohumeral angle on subcoracoid impingement using MRI.

Material and Method: A total of 255 patients (115 men with a mean age of 51.25±15.77 years and 140 women with a mean age of 53.13±14.75 years) were included in this retrospective study. All MRI examinations were performed in the standard position. Coracoid morphology and subscapularis tendon were evaluated. Coracohumeral distance, coracoglenoid angle, and coracohumeral angle were measured in all cases. One-way ANOVA was used to analyze the differences between the groups. The Tukey post-hoc test was performed for paired comparisons. The Pearson correlation analysis was undertaken to demonstrate the relationship between the variables. Result: Subscapularis tendon rupture was the most common type C coracoid. Coracohumeral distance, coracoglenoid angle and coracohumeral angle values did not significantly differ according to coracoid types (p>0.05). However, there was a statistically significant decrease in coracoglenoid angle and coracohumeral distance values in patients with subscapularis tendon rupture (p=0.000). No difference was found in the mean coracohumeral angle values between the normal tendon, tendinosis and rupture groups (p>0.05). There was a positive correlation between coracohumeral distance and coracoglenoid angle (r=0.239, p<0.001), and a negative correlation between coracoglenoid angle and coracohumeral angle (r=-0.320, p<0.001). Conclusion: Coracohumeral distance and coracoglenoid angle were observed to decrease

in subscapularis tendon pathologies while the coracohumeral angle had not changed. Type C coracoid is an effective and important factor in subcoracoid impingement.

Keywords

magnetic resonance imaging, subscapular tendon, subcoracoid impingement, coracoid process

References

• 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: 2325967113496059.
• Friedman RJ, Bonutti PM, Genez B: Cine magnetic resonance imaging of the subcoracoid region. Orthopedics. 1998; 21:545–8.
• Okoro T, Reddy VR, Pimpelnarkar A: Coracoid impingement syndrome: A literature review. Curr Rev Musculoskelet Med, 2009; 2:51–5.
• 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: 2325967117731996
• 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, 2017; 1758573217744170
• Asal N, Şahan MH. Radiological Variabilities in Subcoracoid Impingement: Coracoid Morphology, Coracohumeral Distance, Coracoglenoid Angle, and Coracohumeral Angle. Med Sci Monit, 2018; 24: 8678-84.
• Gerber C, Terrier F, Ganz R: The role of the coracoid process in the chronic impingement syndrome. J Bone Joint Surg Br, 1985; 67: 703–8.
• Freehill MQ: Coracoid impingement: Diagnosis and treatment. J Am Acad Orthop Surg, 2011; 19: 191–97.
• Giaroli EL, Major NM, Lemley DE, Lee J. Coracohumeral interval imaging in subcoracoid impingement syndrome on MRI. Am J Roentgenol, 2006; 186: 242–46.
• Richards DP, Burkhart SS, Campbell SE: Relationship between narrowed coracohumeral distance and subscapularis tears. Arthroscopy, 2005; 21: 1223–28.
• Hekimoglu B, Aydın H, Kızılgöz V, Tatar IG, Ersan O. Quantitative measurement of humero-acromial, humero-coracoid, and coracoclavicular intervals for the diagnosis of subacromial and subcoracoid impingement of shoulder joint. Clin Imaging, 2013; 37:201–10.
• Nair AV, Rao SN, Kumaran CK, Kochukunju BV: Clinico-radiological correlation of subcoracoid impingement with reduced coracohumeral interval and its relation to subscapularis tears in Indian patients. J Clin Diagn Res, 2016; 10: RC17–20.