title: Correlation of acromial morphology with impingement syndrome and rotator cuff tears.
abstract: OBJECTIVE
  Indications for acromioplasty are based on clinical symptoms and are generally supported by typical changes in acromial morphology on standard radiographs. We evaluated 5 commonly used radiographic parameters of acromial morphology and assessed the association between different radiographic characteristics on the one hand and subacromial impingement or rotator cuff tears on the other.
  
  
  METHODS
  We measured acromial type (Bigliani), acromial slope (AS), acromial tilt (AT), lateral acromial angle (LAA), and acromion index (AI) on standard radiographs from 50 patients with full-thickness supraspinatus tendon tears, 50 patients with subacromial impingement, and 50 controls without subacromial pathology.
  
  
  RESULTS
  The acromial type according to Bigliani was not associated with any particular cuff lesion. A statistically significant difference between controls and impingement patients was found for AS. AT of controls was significantly smaller than that of impingement patients and cuff-tear patients. LAA of cuff-tear patients differed significantly from that of controls and impingement patients, but LAA of controls was not significantly different from that of impingement patients. Differences between impingement patients and cuff-tear patients were also significant. AI of controls was significantly lower than of impingement patients and of cuff-tear patients. A good correlation was found between acromial type and AS.
  
  
  CONCLUSIONS
  A low lateral acromial angle and a large lateral extension of the acromion were associated with a higher prevalence of impingement and rotator cuff tears. An extremely hooked anterior acromion with a slope of more than 43° and an LAA of less than 70° only occurred in patients with rotator cuff tears.
authors: Department of Trauma and Orthopedic Surgery, University of Witten-Herdecke, Cologne-Merheim Medical Center, Cologne, Germany. maurice.balke@gmail.com
authors: Maurice
authors: M
authors: Balke
authors: Carolin
authors: C
authors: Schmidt
authors: Nicolas
authors: N
authors: Dedy
authors: Marc
authors: M
authors: Banerjee
authors: Bertil
authors: B
authors: Bouillon
authors: Dennis
authors: D
authors: Liem
mesh_terms: D000174:Acromion / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging*; D012785:Shoulder Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging*