Aims and objectives
Danish patients suspected of impingement syndrome generally have radiographs of their shoulder,
before their first consultation with a surgeon.10
We aimed to describe the prevalence ofrotator cuff calcifications3,4,11as seen in calcific tendinitis of the rotator cuff tendons (fig.2),
osteoarthritis (OA)of the acromioclavicular joint,4,9 (fig.
2),
acromial spurs4,6,7,8 (fig.
3 and 4),
and a hooked acromion1,2,4 (Bigliani type 3) (fig.
5) on standard radiographs.
We hypothesized that these findings are associated with shoulder disability in terms of a Oxford Shoulder Score5 (OSS) below 25 points.
Methods and materials
We conducted a cross-sectional study of all 1039 patients aged 18-63 years,
who were suspected of impingement syndrome based on the referral letter and who responded a questionnaire,
which included OSS and duration of pain prior to their first visitto one of six orthopaedic departments in Central Denmark Region during 2011.
Radiographs available at time of referral were examined by one of two resident doctors,
who were blinded to symptoms and clinical findings.
We usedImpaxversion 6.5 for evaluation of radiographs.
Data was analyzed with logistic...
Results
Radiographs were available for850 patients (81.8%) Mean OSS was 27.6
The prevalence of radiographic findings was: 24.4% for calcifications,
15.8% for a hooked acromion,
12% for acromioclavicular OA,
11.1% for lateral spurs,
and 6.6% for medial spurs.
Lateral spurs were associated with a low OSS with an OR of 2.0 (95% CI 1.2;3.2).
No association was seen between any of the other radiographic findings and a low OSS.
In sex-specific analyseswe found and OR of 2.3 (95% CI 1.1;4.5) among male patients with acromioclavicular OA....
Conclusion
One fourth of all patients referred for orthopaedic evaluation on suspicion of impingement syndrome had rotator cuff calcifications on radiographs.
The calcifications have no significant association with patient-reportedshoulder symptoms as measured by Oxford Shoulder Score.
Lateral acromial spurs areassociated with a low Oxford Shoulder Score,
in particular among female patients.
Radiological signs of osteoarthritis of the acromioclavicularjointis associated with a lowOxford Shoulder Scoreamong male patients.
Personal information
Linda Christie Andrea,
MD,
PhD-student
Regional Hospital Silkeborg
Diagnostic Center,
dept.
of radiology
Falkevej 4
DK-8600 Silkeborg
Denmark
Phone: +45 7841 7565
e-mail:
[email protected]
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