X-ray of shoulder impingement

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Revision as of 17:25, 20 December 2018 by Mikael Häggström (talk | contribs) (→‎Evaluation: +If decreased)
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Author: Mikael Häggström [notes 1]

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

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.

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

  1. 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.

References

  1. 1.0 1.1 1.2 Claes J. Petersson & lnga Redlund- Johnell (1984). "The subacromial space in normal shoulder radiographs ". Acta Orthop Scanda 55 (1): 57–8. PMID 6702430.