X-ray of shoulder impingement
Revision as of 17:25, 20 December 2018 by Mikael Häggström (talk | contribs) (→Evaluation: +If decreased)
Author:
Mikael Häggström [notes 1]
Contents
Planning
X-ray of the shoulder that should include:
- Frontal with and without external rotation of the shoulder
- Scapular outlet view
Evaluation
File:Subacromial space on outlet view X-ray.jpg
Supraspinatus outlet view X-ray, showing subacromial space measurement, and an acromial spur (above the arrow).
- Measurement of the subacromial space. This is normally 9–10 mm in shoulder radiographs.[1] It is significantly greater in men, with a slight reduction with age.[1] In middle age, a subacromial space less than 6 mm is pathological.[1]
- In case of decreased subacromial space, also measure the position of the humerus as described at X-ray of rotator cuff tear
- Shape of the acromion, at least for the presence of any acromial spur
- Flat acromion.jpg
Flat
- Curved acromion.jpg
Curved
- Hooked acromion.jpg
Hooked
Also look for common differential diagnoses or worsening factors of shoulder impingement:
- Osteoarthritis. For severity grading, see X-ray of osteoarthritis of the shoulder
- Presence of any calcifications in the supraspinatus tendon, which indicates a differential diagnosis of calcific tendonitis.
- X-ray of supraspinatus calcified tendinopathy, labeled.jpg
Calcifications in the supraspinatus tendon.
Report
- Either normal subacromial space, or a decrease thereof, with measurement of the space.
- Presence or absence of an acromial spur.
A more comprehensive report mentions the acromial shape regardless.
- See also: General notes on reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.