Türk popülasyonunda akromion morfolojisinin subakromial impingement ve rotator manşet yırtıkları ile ilişkisi

Amaç: Akromion tipleri ve os akromiale varlığının subakromial impingement ve rotator manşet yırtıkları ile ilişkisini manyetik rezonans görüntüleme aracılığıyla incelemeyi amaçladık. Gereç ve Yöntem: 18-85 yaş arasında omuz MR çekimi olan hastalar (n=573) çalışmaya dahil edildi ve cerrahi öyküsü bulunan hastalar (n=34), travma öyküsü ve fraktürü olanlar (n=23) çalışamadan çıkarıldı. 516 hastanın 516 omuz MR çekiminde os akromiale varlığı ve akromion tipleri belirlendi. Supraspinatus kasında impingement bulgusu olarak proton ağırlıklı görüntülerde hiperintens sinyal artımı ve yırtıkları değerlendirildi. Os akromiale varlığı ve akromion tipleri, supraspinatus sinyal artımı ve yırtıkları her hasta için aynı radyolog tarafından belirlendi. Bulgular: Supraspinatus tendonundada sinyal artışı olanlarda os akromiale %4 görülürken, sinyal artışı olmayanlarda %0.008 görüldü. Supraspinatus tendonunda yırtığı olanlarda os akromiale %0.06 görülürken, yırtığı olmayanlarda %0.02 görüldü. Os akromiale ile supraspinatus yırtığı arasında anlamlı ilişki izlenmedi (p=0.055). Os akromiale ile supraspinatus sinyali arasında ise anlamlı ilişki mevcuttu (p=0.043). Akromion tiplerinden Tip I ve Tip III ile supraspinatus sinyal artışı arasında anlamlı ilişki mevcuttu (sırasıyla; p=0.028, p=0.029). Ayrıca, Tip I ve Tip III akromionun supraspinatus tendonu yırtığı ile de anlamlı ilişkisi mevcuttu (sırasıyla; p=0.009, p=0.0061). Sonuç: Tip I ve Tip III akromion subakromial impingement sendromu ve supraspinatus tendon yırtığı açısından risk oluşturmaktadır. Os akromiale varlığıda impingement açısından risk oluşturan bir anatomik varyasyondur.

Objective: We aimed to investigate the association of acromion types and os acromiale presence with subacromial impingement and rotator cuff ruptures by Magnetic Resonance Imaging. Material and Methods: Patients with shoulder MR images between 18-85 years of age (n = 573) were included in the study, and patients with a history of surgery (n = 34), trauma history and fracture (n = 23) were excluded from the study. 516 patients with 516 shoulder MR images, the presence of os acromiale and acromion types were determined. In supraspinatus muscle, hyperintense increased signaland tears in proton weighted images were evaluated as signs of impingement. The presence of os acromiale and acromion types, supraspinatus increased signaland tears were determined by the same radiologist for each patient. Results: In patients with increased signal in supraspinatus, os acromiale was 4%.os acromiale was seen in 0.008% of the patients without signal enhancement.In supraspinatus tears, os acromiale was seen in 0.06%. Os acromiale was seen in 0.02%of the patients without supraspinatus tears. There was no significant correlation between os acromiale and supraspinatus tears (p = 0.055).There was a significant correlation between os acromiale and supraspinatus signal (p = 0.043).There was a significant correlation between acromion types in Type I and Type III in terms of supraspinatus signal increase (p = 0.028, p = 0.029, respectively).In addition, Type I and Type III acromion were significantly associated with supraspinatus tendon tears (p = 0.009, p = 0.0061, respectively). Conclusion: Type I and Type III acromion are significant in terms of subacromial impingement syndrome and supraspinatus tendon tears. Os acromiale is an anatomic variation that poses a risk for subacromial impingement.

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