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Multiplanar analysis of acromion morphology

J D MacGillivray1, S Fealy, H G Potter

  • 1Department of Sports Medicine and Shoulder Service, Hospital For Special Surgery, Cornell University Medical Center, New York, NY 10021, USA.

The American Journal of Sports Medicine
|December 16, 1998
PubMed
Summary

Acromion morphology, including its slope and angulation, is linked to shoulder impingement syndrome. Older individuals tend to have more hooked acromions, increasing impingement risk.

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Area of Science:

  • Orthopedics
  • Radiology
  • Anatomy

Background:

  • Shoulder impingement syndrome is a common cause of shoulder pain.
  • Acromion morphology is believed to play a role in the development of impingement syndrome.
  • Previous studies have suggested a link between acromion shape and impingement, but detailed morphological analysis is lacking.

Purpose of the Study:

  • To comprehensively describe acromion morphology using advanced imaging techniques.
  • To investigate the relationship between specific acromion parameters and the presence and severity of shoulder impingement syndrome.
  • To analyze how acromion morphology changes with age.

Main Methods:

  • Three-dimensional magnetic resonance imaging (MRI) and computed tomography (CT) were used to evaluate acromion morphology in 132 symptomatic shoulders.

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  • Four parameters were assessed: anterior slope angle (midsagittal and lateral-sagittal planes), lateral acromial angulation (coronal plane), and medial encroachment.
  • Asymptomatic shoulders (N=25) served as controls. Imaging data from both modalities were combined due to lack of significant differences.

    • Main Results:

    • Mean acromion angles were 19.4° (midsagittal) and 20° (lateral-sagittal).
    • 97% of acromions were neutral, while 27% showed downward sloping in the coronal plane.
    • Medial encroachment was present in 24% of shoulders. A significant age-related transition from flat to hooked acromions was observed.
    • Downward sloping acromions and medial encroachment were strongly associated with impingement syndrome (stages II/III).

    Conclusions:

    • Acromion morphology, particularly its slope and angulation, is significantly related to shoulder impingement syndrome.
    • Age is a factor in acromion morphology, with older individuals exhibiting more hooked shapes.
    • Specific morphological features like downward sloping and medial encroachment are strong indicators of impingement, suggesting their importance in diagnosis and treatment planning.