Title: Relationship between Critical Shoulder Angle and Rotator Cuff Tears in Patients with Non-Traumatic Shoulder Pain

Authors: Dr Sowmya Uppalapati, Dr Sumana Bingi, Dr K. Sujatha Chandrasekhar

 DOI: https://dx.doi.org/10.18535/jmscr/v9i12.21

Abstract

Introduction

Rotator cuff tears are the most common cause of pain and restricted movements of the shoulder joint. They can be due to traumatic or degenerative causes. The prevalence of rotator cuff tears (full thickness) ranges from 5% to 40% and their incidence increases progressively with the advancing age. Based on history and physical examination, the interpretation of the integrity of rotator cuff muscles helps in diagnosis of tears. A shoulder radiograph is usually done to assess osseous anatomy, fractures, dislocations, and osteoarthritis changes. However, certain indirect signs related to acromial morphology such as type of acromion, its thickness, spurs, acromio-humeral distance, and lateral acromial angle have also been attributed to the rotator cuff disease. Critical shoulder angle was proposed by Moor et al, as a new radiologic parameter to measure the lateral acromial projection. In the present study, we aim to evaluate the influence of CSA as a predisposing factor for development of non-traumatic RCTs.

Aims and Objectives

To determine the relationship between critical shoulder angle and non-traumatic rotator cuff tears.

References

  1. Moor BK, Bouaicha S, Rothenfluh DA, Sukthankar A, Gerber C. Is there an association between the individual anatomy of the scapula and the development of rotator cuff tears or osteoarthritis of the glenohumeral joint?: A radiological study of the critical shoulder angle. Bone Joint J. 2013 Jul;95-B(7):935-41. doi: 10.1302/0301-620X.95B7.31028. PMID: 23814246.
  2. Suter T, Gerber Popp A, Zhang Y, Zhang C, Tashjian RZ, Henninger HB. The influence of radiographic viewing perspective and demographics on the critical shoulder angle. J Shoulder Elbow Surg. 2015 Jun;24(6):e149-58. doi: 10.1016/j.jse.2014.10.021.
  3. Neer, Charles S. II, M.D.* Impingement Lesions, Clinical Orthopaedics and Related Research: March 1983 - Volume 173 - Issue - p 70-77.
  4. Watson-Jones R. Fractures and Joint Injuries. Vol. 2. Baltimore: Williams & Wilkins; 1940. Fractures and joint injuries. [Google Scholar].
  5. Armstrong JR. Excision of the acromion in treatment of the supraspinatus syndrome; report of 95 excisions. J Bone Joint Surg Br. 1949;31B:436-42. [CrossRef] [Google Scholar]
  6. Nyffeler RW, Werner CM, Sukthankar A, Schmid MR, Gerber C. Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am. 2006 Apr;88(4):800-5. doi: 10.2106/JBJS.D.03042. PMID: 16595470.
  7. Gerber C, Catanzaro S, Betz M, Ernstbrunner L. Arthroscopic Correction of the Critical Shoulder Angle Through Lateral Acromioplasty: A Safe Adjunct to Rotator Cuff Repair. Arthroscopy. 2018 Mar;34(3):771-780. Doi: 10.1016/j.arthro.2017.08.255. PMID: 29100767.
  8. Li H, Chen Y, Chen J, Hua Y, Chen S. Large critical shoulder angle has higher risk of tendon retear after arthroscopic rotator cuff repair. Am J Sports Med. 2018;46(8):1892–900.
  9. Cherchia L, Ciornohaca JF, Godetb J, Claverta P, Kempfa JF (2016) Critical shoulder angle: Measurement reproducibility and correlation with rotator cuff tendon tears. Orthopaedics & Traumatology. Surgery & Research 102: 559-562.
  10. Moor BK, Röthlisberger M, Müller DA, et al. Age, trauma and the critical shoulder angle accurately predict supraspinatus tendon tears. Orthop Traumatol Surg Res 2014;100:489–94. [PubMed] [Google Scholar].
  11. Macaulay AA, Greiwe RM, Bigliani LU. Rotator Cuff Deficient Arthritis of the Glenohumeral Joint. Clin Orthop Surg 2010;2:196. [PMC free article] [PubMed] [Google Scholar]

Corresponding Author

Dr Sowmya Uppalapati

Post Graduate,Department of Radiodiagnosis, Mediciti Institute of Medical Sciences, Ghanpur, Telangana, India