SUPRASPINATUS TENDİNİTİ VE SCAPULA MORFOMETRİK PARAMETRELERİ ARASINDAKİ İLİŞKİ

Amaç: Tendinit en sık görülen omuz lezyonlarından biridir. Bu çalışmanın amacı, kritik omuz açısı (OKA), glenoid eğimi (GI) ve akromiyon indeksi (AI) dahil olmak üzere radyolojik parametrelerin supraspinatus tendinit ile korelasyonunu değerlendirmektir. Gereç ve Yöntem: Çalışmaya 72 hasta (47 erkek, 27 kadın, yaş ortalaması 29 ± 5.2 (18-40)) dahil edildi. Omuz manyetik rezonans görüntüleri ;supraspinatus tendonundaki sinyal artışına göre normal olan Grup I (n = 33) ve yüksek olan Grup II (n = 41) olmak üzere iki gruba ayrıldı.Nötr pozisyonda elde edilen omuz radyografilerinde kritik omuz açısı, glenoid eğim ve akromiyon indeksiparametreleri ölçüldü. Radyolojik parametreler ile supraspinatus tendinit varlığı arasındaki ilişki değerlendirildi. Bulgular: Grup I'de Ortalama OKA 37.9 °, ortalama GI 17.2 ° ve ortalama AI 0.8 idi. Grup II'de Ortalama OKA 38.3 °, ortalama GI 17.1 ° ve ortalama AI 0.8 idi. Gruplar arasında istatistiksel olarak anlamlı bir fark bulunmadı. Kadınların OKA değerleri erkeklerden istatistiksel olarak anlamlı derecede yüksekti (p = 0,04). Sonuç: Yüksek OKA değerlerinin rotator manşet yırtığı ve düşük OKA değerlerinin osteoartrit ile ilişkili olduğu bulunmuştur. Çalışmamızda supraspinatus tendinit ile OKA, AI ve GI parametreleri arasında ilişki saptamadık.Supraspinatusun erken tanısında kullanılmak üzere yeni morfometrik parametrelere ihtiyaç vardır.

Anahtar Kelimeler:

Tendinit, Omuz Kritik Açısı, Glenoid eğimi, Akromıon açısı

THE RELATIONSHIP BETWEEN THE MORPHOMETRIC PARAMETERS OF SCAPULA AND SUPRASPINATUS TENDONITIS

OBJECTIVE: Tendonitis is one of the most frequent shoulder lesions. The aim of this study is to evaluate the correlation of the radiological parameters including critical shoulder angle (CSA), glenoid inclination (GI) and acromion index (AI) with supraspinatus tendonitis.MATERIALS AND METHODS : Seventy-four patients [47 men, 27 women, mean age 29±5.2 (range 18-40)] were included in the study. Two groups were formed as Group I (n=33) and Group II (n=41) according to supraspinatus tendon intensity revealed by shoulder magnetic resonance images. Critical shoulder angle, glenoid inclination and acromion index parameters were measured on shoulder radiographs obtained in neutral position. The relationship of the radiologic parameters and the presence of supraspinatus tendonitis was evaluated. RESULTS: The mean CSA was 37.9°, the mean GI was 17.2°, and the mean AI was 0.8 in Group I. The mean CSA was 38.3°, the mean GI was 17.1°, and the mean AI was 0.8 in Group II. No statistically significant difference was found between the groups. The CSA values of the women were statistically significantly higher than that of the men (p=0.04). CONCLUSIONS: Higher CSA values are found to be associated with the risk of rotator cuff tear and lower CSA values with osteoarthritis. Higher angles are associated with increased risk of supraspinatus tendonitis tear. Supraspinatus tendonitis is not associated with the morphometric parameters including CSA, AI and GI. New morphometric parameters should be identified and their relation with supraspinatus tendonitis should be investigated for early diagnosis.

Keywords:

Tendinitis; Critical shoulder angle; Glenoid inclination;, Acromion index,

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Referans1- Blevins FT (1997) Rotator Cuff pathology in athletes. Sports Med 24:205-220.
Referans2- Jo CH, Shin WH, Park JW et al(2017) Degree of tendon degeneration and stage of rotator cuff disease. Knee Surg Sports Traumatol Arthrosc 25:2100-2108.
Referans3- Bigliani LU, Ticker JB, Flatow EL et al(1991) The relationship of acromial architecture to rotator cuff disease. Clin Sports Med 10:823-838.
Referans4- Davidson PA, Elattrache NS, Jobe CM et al(1995) Rotator cuff and posterior-superior glenoid labrum injury associated with increased glenohumeral motion: a new site of impingement. J Shoulder Elbow Surg 4:384-390.
Referans5- Hughes RE, Bryant CR, Hall JM et al(2003) Glenoid inclination is associated with full-thickness rotator cuff tears. Clin Orthop Relat Res 407:86-91.
Referans6- Kim JR, Ryu KJ, Hong IT et al(2012) Can a high acromion index predict rotator cuff tears? Int Orthop 36:1019-1024.
Referans7- Neer CS (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54:41-50.
Referans8- Nove-Josser L, Edwards TB, O’Connor DP et al (2005)The acromiohumeral and coracohumeral intervals are abnormalin rotator cuff tears with muscular fatty degeneration. Clin Orthop Relat Res 433:90-96.
Referans9- Nyffeler RW, Werner CM, Sukthankar Adet al (2006)Association of a large lateral extension of the acromion with rotator cuff tears. J Bone Joint Surg Am88:800-805.
Referans10- Moor BK, Bouaicha S, Rothenfluh DA et al (2013)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.95:935–941.
Referans11- Viehöfer AF, Snedeker JG, Baumgartner D(2016) Glenohumeral Joint Reaction Forces Increase With Critical Shoulder Angles Representative of Osteoarthritis-A Biomechanical Analysis. J Orthop Res 34:1047-1052.
Referans12- Gerber C, Snedeker JG, Baumgartner D et al (2014)Supraspinatus Tendon Load During Abduction Is Dependent on the Size of the Critical Shoulder Angle: A Biomechanical Analysis. J Orthop Res 32:952-957.
Referans13- Viehöfer AF, Gerber C, Favre P et al (2016) A Larger Critical Shoulder Angle Requires More Rotator Cuff Activity to Preserve Joint Stability. J Orthop Res.34:961-968.
Referans14- Bouaicha S, Ehrmann C, Slankamenac K et al (2014) Comparison of the critical shoulder angle in radiographs and computed tomography. Skeletal Radiol 43:1053-1056.
Referans15- Cherchi L, Ciornohac JF, Godet J et al (2006) Critica lshoulder angle: Measurement reproducibility and correlation with rotator cuff tendon tears.Orthop Traumatol Surg Res 102:559-562.
Referans16- Hermans J, Luime JJ, Meuffels DE et al(2013) Does this patient with shoulder pain have rotatorcuffdisease?: The Rational Clinical Examination systematic review.JAMA 310:837-847.
Referans17- Papadonikolakis A, McKenna M, Warme W et al (2011)Published evidence relevant to the diagnosis of impingement syndrome of the shoulder. J Bone Joint Surg Am 93;1827-1832.
Referans18- Bauer S, Wang A, Butler R et al (2014) Reliability of a 3 T MRI protocol for objective grading of supraspinatus tendonosis and partial thickness tears . J Orthop Surg Res 9:128.
Referans19- Bjarnison AO, Sorensen TJ, Kallemose Tet al(2017) The critical shoulder angle is associated with osteoarthritis in the shoulder but not rotator cuff tears: a retrospective case-control study.J Shoulder Elbow Surg 26:2097-2102.
Referans20- Spiegl UJ, Horan MP, Smith SW, et al (2016)The critical shoulder angle is associated with rotator cuff tears and shoulder osteoarthritis and is better assessed with radiographs over MRI. Knee Surg Sports Traumatol Arthrosc 24:2244-2251.
Referans21- Daggett M, Werner B, Collin P et al (2015) Correlation between glenoid inclination and critical shoulder angle: a radiographic and computed tomography study. J Shoulder Elbow Surg 24:1948–1953.
Referans22- Gomide LC, Carmo TCD, Bergo GHM et al (2017)Relationship between the critical shoulder angle and the development of rotator cuff lesions: a retrospective epidemiological study Rev Bras Ortop 52:423-427.
Referans23- Miswan M, Saman MS, Hui TS et al (2017)Correlation between anatomy of the scapula and the incidence of rotator cuff tear and glenohumeral osteoarthritis via radiological study.J Orthop Surg 25:1-5.
Referans24- Blonna D, Giani A, Bellato E et al (2016)Predominance of the critical shoulder angle in the pathogenesis of degenerative diseases of the shoulder. J Shoulder Elbow Surg 25:1328-1336.
Referans25- Hanciau FA, da Silva MA, Martins FS et al (2015) Association clinical-radiographic of the acromion índex and the lateral acromion angle. Rev Bras Ortop 47:730-735.
Referans26- Hamid N, Omid R, Yamaguchi K et al (2012)Relationship of radiographic acromial characteristics and rotator cuff disease: a prospective investigation of clinical, radiographic, and sonographic findings. J Shoulder Elbow Surg 21:1289-1298.
Referans27- Tétreault P, Krueger A, Zurakowski D et al (2004)Glenoid version and rotator cuff tears. J Orthop Res22:202-207.
Referans28- Gu G, Yu MY(2013) Imaging features and clinical significance of the acromion morphological variations. J Nov Physiother.S2:003.
Referans29- Engelhardt C, Farron A, Becce F et al(2017)Effects of glenoid inclination and acromion index on humeral head translation and glenoid articular cartilage strain.J Shoulder Elbow Surg 26:157-164.
Referans30- Naidoo N, Lazarus L, Van Tongel A et al (2018)Predictors of Shoulder Degeneration in the KwaZulu-Natal Population of South Africa. Int J Morphol 36;92-96.