title: Rotator cuff tears: association with acromion angulation on MRI.
abstract: OBJECTIVE
  Using magnetic resonance imaging (MRI), evaluate the correlation of acromion angulation with thickening of the coracoacromial ligament (CAL) and narrowing of the subacromial space resulting in impingement upon the rotator cuff tendons.
  
  
  METHODS
  Eighty-nine shoulder MRI studies performed on a 3T scanner were retrospectively analyzed by two blinded independent reviewers. Measurements of the acromion angle (delta angle), CAL thickness and distance between the CAL and humeral head were obtained. The data were categorized into two groups, delta angle less that and greater than 7.5°. The presence or absence of full thickness (FT) or near full thickness (NFT) rotator cuff tears was noted.
  
  
  RESULTS
  In group 1, the acromion angle varied from -6.8 to 6.8° (1.7±3.5°) with a CAL thickness of 0.91±0.20 mm and a subacromial distance of 6.47±0.88 mm. Group 2 acromion angle varied from 7.6° to 46.8° (18.0°±8.1°) with a CAL of 1.77±0.51 mm and a subacromial distance of 4.52±0.82 mm. The difference in CAL thickness and subacromial distance were significantly different between the two groups (P<.001). In Group 1, 3 out of 51 patients had a FT or NFT tear of the rotator cuff compared to 20 out of 38 in Group 2 (P<.001). There was no significant interobserver variability.
  
  
  CONCLUSIONS
  Steep acromion angulation is associated with CAL thickening and narrowing of the subacromial space. Patients with a steep acromion angle had a statistically increased incidence of rotator cuff tears.
authors.affiliation: Casper Medical Imaging, Casper, WY, USA. mcgjoe26@yahoo.com
authors.forename: Joseph C
authors.initials: JC
authors.lastname: McGinley
authors.forename: Sundeep
authors.initials: S
authors.lastname: Agrawal
authors.forename: Sandip
authors.initials: S
authors.lastname: Biswal
mesh_terms: D000174:Acromion / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D017006:Rotator Cuff / Q000473:pathology*; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D019534:Shoulder Impingement Syndrome / Q000209:etiology / Q000473:pathology*; D055815:Young Adult