title: Compared to X-ray, three-dimensional computed tomography measurement is a reproducible radiographic method for normal proximal humerus.
abstract: BACKGROUND
  Accurate comprehension of the normal humeral morphology is crucial for anatomical reconstruction in shoulder arthroplasty. However, traditional morphological measurements for humerus were mainly based on cadaver and radiography. The purpose of this study was to provide a series of precise and repeatable parameters of the normal proximal humerus for arthroplasty, based on the three-dimensional (3-D) measurements.
  
  
  METHODS
  Radiographic and 3-D computed tomography (CT) measurements of the proximal humerus were performed in a sample of 120 consecutive adults. Sex differences, two image modalities differences, and correlations of the parameters were evaluated. Intra- and inter-observer reproducibility was evaluated using intraclass correlation coefficients (ICCs).
  
  
  RESULTS
  In the male group, all parameters except the neck-shaft angle of humerus, based on 3-D CT images, were greater than those in the female group (P < 0.05). All variables were significantly different between two image modalities (P < 0.05). In 3-D CT measurement, all parameters expect neck-shaft angle had correlation with each other (P < 0.001), particularly between two diameters of the humeral head (r = 0.907). All parameters in the 3-D CT measurement had excellent reproducibility (ICC range, 0.878 to 0.936) that was higher than those in the radiographs (ICC range, 0.741 to 0.858).
  
  
  CONCLUSIONS
  The present study suggested that 3-D CT was more reproducible than plain radiography in the assessment of morphology of the normal proximal humerus. Therefore, this reproducible modality could be utilized in the preoperative planning. Our data could serve as an effective guideline for humeral component selection and improve the design of shoulder prosthesis.
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China.
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Jia
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China. cyxtongji@126.com.
authors.forename: Yanxi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China.
authors.forename: Minfei
authors.initials: M
authors.lastname: Qiang
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China.
authors.forename: Haobo
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China.
authors.forename: Yuchen
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, 150 Jimo Road, 200120, Shanghai, China.
authors.forename: Yijie
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D058430:Humeral Head / Q000000981:diagnostic imaging*; D021621:Imaging, Three-Dimensional / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011859:Radiography / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*; D014965:X-Rays; D055815:Young Adult
keywords: Computed tomography; Computer-assisted; Measurement; Shoulder anatomy; Shoulder geometry; Shoulder morphology; Three-dimensional