title: Cranial translation of the humeral head on radiographs in rotator cuff tear patients: the modified active abduction view.
abstract: Cranial translation of the humeral head is related to massive rotator cuff tears; however, it may be unapparent in early-stage tears. The goal of this study was to investigate whether active abduction leads to increased active cranial humeral translation in early-stage tears. We assessed 20 consecutive patients (9 full-thickness supraspinatus tears, 11 posterosuperior tears) using the newly introduced modified active abduction view: acromiohumeral (AH) distance was measured on radiographs acquired during rest and active isometric abduction and adduction tasks with the arm alongside the body. Rest AH was 7.5 mm (SD = 1.53); during abduction and adduction, it decreased to 2.1 mm (95 % CI 1.28-3.01, p < 0.001) and 1.1 mm (95 % CI 0.46-1.65, p = 0.001), respectively. Cranial translation during abduction was more severe in shoulders with posterosuperior cuff tears (∆AH = 3 mm, SD = 1.5) compared to supraspinatus tears (∆AH = 1 mm, SD = 1.6), with a mean difference of 2 mm (95 % CI 0.64-3.58, p = 0.007). Both active isometric abduction and adduction leads to active cranial translation in cuff tear patients. Cranial translation is largest during active abduction. Furthermore, there is significant more cranial translation in posterosuperior cuff tear patients compared to supraspinatus cuff tear patients. Possibly, radiographs combined with active tasks offer new possibilities in diagnosing early-stage rotator cuff tears.
authors.affiliation: Department of Orthopaedics, Leiden University Medical Center, Postzone J11-R, Postbus 9600, 2300 RC, Leiden, The Netherlands, j.f.henseler@lumc.nl.
authors.forename: J F
authors.initials: JF
authors.lastname: Henseler
authors.forename: P B
authors.initials: PB
authors.lastname: de Witte
authors.forename: J H
authors.initials: JH
authors.lastname: de Groot
authors.forename: E W
authors.initials: EW
authors.lastname: van Zwet
authors.forename: R G H H
authors.initials: RG
authors.lastname: Nelissen
authors.forename: J
authors.initials: J
authors.lastname: Nagels
mesh_terms: D006801:Humans; D058430:Humeral Head / Q000000981:diagnostic imaging*; D006811:Humerus / Q000293:injuries; D007537:Isometric Contraction; D011859:Radiography; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging
references.citation: J Biomech. 2009 Aug 7;42(11):1740-5
references.pmid: 19450803
references.citation: J Shoulder Elbow Surg. 2000 May-Jun;9(3):183-7
references.pmid: 10888161
references.citation: J Bone Joint Surg Br. 1970 Aug;52(3):524-7
references.pmid: 5455085
references.citation: Hum Mov Sci. 2012 Apr;31(2):461-71
references.pmid: 22341875
references.citation: Man Ther. 2006 Aug;11(3):231-7
references.pmid: 16890886
references.citation: Clin Orthop Relat Res. 2007 Feb;455:52-63
references.pmid: 17179786
references.citation: Clin Orthop Relat Res. 2006 Oct;451:73-9
references.pmid: 16788406
references.citation: J Shoulder Elbow Surg. 2010 Jan;19(1):10-3
references.pmid: 19556147
references.citation: J Shoulder Elbow Surg. 1996 May-Jun;5(3):186-93
references.pmid: 8816337
references.citation: Eur J Radiol. 2008 Oct;68(1):2-15
references.pmid: 18599231
references.citation: J Biomech. 2005 Apr;38(4):755-60
references.pmid: 15713296
references.citation: Clin Biomech (Bristol, Avon). 1999 Jun;14(5):309-14
references.pmid: 10521607
references.citation: Clin Biomech (Bristol, Avon). 2006 Jul;21(6):545-53
references.pmid: 16603286
references.citation: Clin Biomech (Bristol, Avon). 2010 Mar;25(3):187-93
references.pmid: 20004504
references.citation: N Engl J Med. 2008 May 15;358(20):2138-47
references.pmid: 18480206
references.citation: J Shoulder Elbow Surg. 2010 Dec;19(8):1137-44
references.pmid: 20598916
references.citation: J Shoulder Elbow Surg. 2008 Mar-Apr;17(2):241-7
references.pmid: 18234527
references.citation: J Shoulder Elbow Surg. 1999 Sep-Oct;8(5):438-42
references.pmid: 10543596
references.citation: J Bone Joint Surg Am. 2009 Jun;91(6):1405-13
references.pmid: 19487518
references.citation: Clin Orthop Relat Res. 2006 Feb;443:260-5
references.pmid: 16462449
references.citation: Ann Rheum Dis. 2001 Apr;60(4):322-6
references.pmid: 11247859
references.citation: J Biomech. 2010 Aug 10;43(11):2049-54
references.pmid: 20452596
references.citation: J Shoulder Elbow Surg. 2001 Sep-Oct;10(5):428-33
references.pmid: 11641699
references.citation: Am J Sports Med. 2012 Jul;40(7):1611-9
references.pmid: 22582227
references.citation: J Bone Joint Surg Am. 1972 Jan;54(1):41-50
references.pmid: 5054450
references.citation: J Bone Joint Surg Am. 1995 Jan;77(1):10-5
references.pmid: 7822341
references.citation: Skeletal Radiol. 1991;20(4):255-8
references.pmid: 1853216
references.citation: J Shoulder Elbow Surg. 1996 Jan-Feb;5(1):47-52
references.pmid: 8919442
references.citation: Acta Orthop Scand. 1996 Jun;67(3):258-63
references.pmid: 8686464