TÜRK POPÜLASYONUNDA OS AKROMİALE PREVALANSI VE MANYETİK REZONANS GÖRÜNTÜLEME İLE SUBAKROMİYAL MESAFE VE AKROMİYON TİPOLOJİSİNİN DEĞERLENDİRİLMESİ

Amaç: Bir Türk popülasyonunda akromiyon tipi, os acromiale prevalansını ve akromion tipolojisinin subakromiyal mesafe ile ilişkisini belirlemek.Gereç ve Yöntem: Dahil etme kriterlerini karşılayan toplam 528 hasta, os akromiale varlığı, akromiyon tipive subakromial mesafe açısından iki radyolog tarafından değerlendirildi. Akromion tipolojisi, os akromialeolmayan hastalarda değerlendirildi. Os akromion, subakromial mesafedeki değişiklikler istatistiksel olarakcinsiyet, etkilenen taraf (sağ / sol) varlığına bağlı olarak değerlendirildi. Ayrıca, subakromial mesafe ile akromion türleri arasındaki ilişki araştırıldı.Bulgular: On iki hastada (% 2.27) os akromiale vardı. Yüz on altı hastada tip I akromion (% 22.5) varken, 352hastada tip II akromion (% 68.2), 10 hastada tip III akromion (% 1.9) ve 38 hastada da tip IV akromion (% 7.4)vardı. Ortalama subakromial mesafe 6.6 mm (% 95; 6.5-6.77 mm) olarak bulundu. Akromion tipine göre,subakromial mesafe tip IV akromionda tip I ve II'ye göre anlamlı derecede yüksekti (p = 0.02). Subakromialmesafede cinsiyet ve taraf açısından anlamlı fark yoktu (sırasıyla p = 0.309 ve 0.454).Sonuç: Türk popülasyonunda cinsiyete ve tarafa göre subakromial mesafede anlamlı bir fark yoktu. Değerlendirilen Türk popülasyonunda en sık ve en yaygın akromion türü sırasıyla tip II ve tip III idi. Subakromiyalmesafe tip 4 akromionda daha büyüktü.

Os Acromiale Prevalence and Evaluation of Subacromial Distance and Acromion Typology by Magnetic Resonance Imaging in a Turkish Population

Purpose: To determine the prevalence of acromion type, os acromiale, and the relation of acromion typology with subacromial distance in a Turkish population. Materials and Methods: A total of 528 patients who met the inclusion criteria were evaluated in terms of presence of os acromiale, type of acromion, and subacromial distance by two radiologists. Acromion typology was evaluated in patients without os acromiale. Variations of subacromial distance depending on the presence of os acromion, sex, affected side (right / left) were statistically assessed. In addition, an association between subacromial distance and acromion types was sought. Results: Twelve patients (2.27%) had os acromiale. One-hundred and sixteen patients had type I acromion (22.5%) whereas 352 had type II acromion (68.2%), 10 had type III acromion (1.9%), and 38 had type IV acromion (7.4%). The median subacromial distance was found to be 6.6 mm (95% CI for median; 6.5-6.77 mm). Regarding the acromion type, subacromial distance was significantly higher in type IV acromion than in types I and II (p= 0.02). There was no significant difference in subacromial distance according to sex and side (p=0.309 and 0.454 respectively). Conclusion: There was no significant difference in subacromial distance according to sex and side in the Turkish population. The most and least common types of acromion in the evaluated Turkish population were type II and type III, respectively. The subacromial distance was greater in type 4 acromion.

PDF

___

1. El-Din WAN, Ali MHM. A Morphometric Study of the Patterns and Variations of the Acromion and Glenoid Cavity of the Scapulae in Egyptian Population. J Clin Diagn Res. 2015;9:8-11.
2. Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54:41-50.
3. Balke M, Schmidt C, Dedy N, Banerjee M, Bouillon B, Liem D. Correlation of acromial morphology with impingement syndrome and rotator cuff tears. Acta Orthop. 2013;84:178-83.
4. Gumina S, De Santis P, Salvatore M, Postacchini F. Relationship between os acromiale and acromioclavicular joint anatomic position. J Shoulder Elb Surg. 2003;12:6-8.
5. 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.
6. Bigliani BUME AE. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:216.
7. Vanarthos WJ, Monu JU. Type 4 acromion: a new classification. Contemp Orthop. 1995;30:227-9.
8. Aragao JA, Silva LP, Reis FP, Dos Santos Menezes CS. Analysis on the acromial curvature and its relationships with the subacromial space and types of acromion. Rev Bras Ortop. 2014;49:636-41.
9. Spencer EE, Jr., Dunn WR, Wright RW, Wolf BR, Spindler KP, McCarty E, et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sports Med. 2008;36:99-103.
10. Toivonen DA, Tuite MJ, Orwin JF. Acromial structure and tears of the rotator cuff. J Shoulder Elbow Surg. 1995;4:376-83.
11. Natsis K, Tsikaras P, Totlis T, Gigis I, Skandalakis P, Appell HJ, 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.
12. Kumar J, Park WH, Kim SH, Lee HI, Yoo JC. The prevalence of os acromiale in Korean patients visiting shoulder clinic. Clin Orthop Surg. 2013;5:202-8.
13. Sammarco VJ. Os acromiale: frequency, anatomy, and clinical implications. J Bone Joint Surg Am. 2000;82:394-400.
14. 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.