scapular radiographics

BACKGROUND: Increased coracoclavicular distance due to acute acromioclavicular joint (ACJ) instability is often described as a pseudoelevation of the clavicle due to inferior hanging of the scapula, while the distal clavicle remains in its position. The aim of this study was to analyze whether the elevation of the distal clavicle, depression of the scapula, or both are associated with vertical instability and to evaluate the impact of weighted stress radiographs on the clavicle and scapular position in acute ACJ instabilities...

BACKGROUND: Superior inclination of the base plate in reverse shoulder arthroplasty (RSA) is underestimated and may lead to major setbacks in terms of functional outcomes due to the altered biomechanics. Joint instability, scapular notching, and loosening of the glenoid component are considered the most serious sequelae. Therefore, a thorough preoperative radiological assessment of the affected shoulder joint and customized design of the prosthesis according to the glenoid morphology are decisive and directly correlated to the outcome...

We report a case of an osteoid osteoma at the scapular glenoid that was treated with cryoablation. The patient presented with shoulder pain with subsequent CT and MRI imaging findings suspicious for an osteoid osteoma. The patient complained of persistent pain despite medical treatment and was referred to interventional radiology for consideration of ablation. CT-guided biopsy confirmed the diagnosis of osteoid osteoma and the patient underwent cryoablation of the lesion in the same session. The patient reported a substantial relief in her pain at a follow-up 4 weeks after the procedure...

Overhead throwing, particularly in baseball, subjects the shoulder and elbow to various unique injuries. Capsular contracture following repetitive external rotation shifts the humeral head posterosuperiorly, predisposing to glenohumeral internal rotation deficit (GIRD), Bennett, posterosuperior internal impingement (PSI), and superior labrum anterior-posterior (SLAP) lesions. GIRD represents loss of internal rotation at the expense of external rotation. Bennett lesion represents ossification of the posteroinferior glenohumeral ligament due to repetitive traction...

BACKGROUND: Augmented glenoid baseplate and offset humeral tray reverse total shoulder arthroplasty (RTSA) implants may decrease the mechanical impingement that creates scapular notching and improve shoulder function. This study evaluated the clinical efficacy of three different RTSA glenoid baseplate and offset humeral tray combinations for patient-reported shoulder function, pain and instability, radiographic imaging evidence of glenoid baseplate or humeral stem subsidence and migration, bony changes associated with implant loosening, and scapular notching over the initial 2 years post-RTSA...

BACKGROUND: The use of reverse shoulder arthroplasty (RSA) is becoming increasingly prevalent. However, few studies have been published reporting the long-term outcomes of RSA. This study aims to report the clinical, radiographic, and patient-reported outcomes of the Delta Xtend reverse shoulder prosthesis, performed by a single surgeon and with a minimum follow-up of 10 years. METHODS: All RSA procedures performed between 2005 and 2012 were identified. Patients were contacted and invited for a follow-up visit including clinical assessment, radiographs, and patient-reported outcome measures (PROMs)...

BACKGROUND: Patient-specific scapular shape in functional posture can be highly relevant to clinical research. Biplanar radiography is a relevant modality for that purpose with already two existing assessment methods. However, they are either time-consuming or lack accuracy. The aim of this study was to propose a new, more user-friendly and accurate method to determine scapular shape. METHODS: The proposed method relied on simplified manual inputs and an upgraded version of the first 3D estimate based on statistical inferences and Moving-Least Square (MLS) deformation of a template...

BACKGROUND: The Walch classification is commonly utilized by surgeons when determining the treatment of osteoarthritis (OA). However, its utility in prognosticating patient clinical state before and after TSA remains unproven. We assessed the prognostic value of the modified Walch glenoid classification on preoperative clinical state and postoperative clinical and radiographic outcomes in total shoulder arthroplasty (TSA). METHODS: A prospectively-collected, multi-center database for a single-platform TSA system was queried for patients with rotator cuff-intact OA and minimum 2 year follow-up after anatomic and reverse TSA (aTSA, rTSA)...

PURPOSE: Acromioclavicular joint (ACJ) dislocations are usually graded radiographically according to Rockwood, but differentiation between Rockwood types III and V may be ambiguous. The potentially clinically relevant horizontal instability is barely addressed in coronal radiographs. It was hypothesized that a new radiologic parameter (V angle) would complement ACJ diagnostics on anteroposterior radiographs by differentiating between cases of Rockwood III and V while also considering the aspect of dynamic horizontal translation (DHT)...

BACKGROUND: Acromion stress fractures (ASF) or scapular spine fractures (SSF) following reverse total shoulder arthroplasty (RTSA) are common complications with impaired clinical outcome. The underlying biomechanical factors remain unclear. The aim of this study was to evaluate basic demographic and radiographic parameters predicting occurrence of different types of ASF/SSF in a large single-center study cohort. METHODS: A total of 860 RTSA (805 patients) with available minimum follow-up of 2 years were implanted between 2005 and 2018 at a tertiary academic center...

BACKGROUND: Prior evidence has identified specific posterior acromial morphology as significantly associated with unidirectional posterior shoulder instability. The purpose of this study is to determine the influence of posterior acromial morphology on the outcomes of arthroscopic posterior capsulolabral repair (APCLR) for unidirectional posterior shoulder instability. Additionally, we sought to determine the influence of posterior acromial morphology on the rate and time to return to pushups following APCLR...

There has been a rapid evolution in best practice management of acromioclavicular (AC) joint injuries. AP, Zanca, scapular Y, and dynamic axillary radiographic views provide optimal visualization of the joint and may assess for the presence of horizontal AC instability. Severity of AC joint pathology is classified according to the 6-tier Rockwood scoring system. Over 160 surgical techniques have been described for AC joint repair and reconstruction in the last decade; as a result, determining the optimal treatment algorithm has become increasingly challenging secondary to the lack of consistently excellent clinical outcomes...

PURPOSE: The utilization of reverse total shoulder arthroplasty now exceeds the incidence of anatomic shoulder arthroplasty. Previous mid-to-long-term studies on rTSA have reported a decrease in shoulder function as follow-up increased. The purpose of this study was to provide data on mid-term outcomes and implant survival in a series focusing on reverse total shoulder arthroplasty. MATERIALS AND METHODS: Demographic information such as age at surgery, revision surgery status, BMI, and smoking status were recorded...

BACKGROUND: Elderly patients and their surgeons may eschew shoulder arthroplasty due to concerns over patient safety and longevity. The purpose of this study was to review the current literature evaluating the clinical and radiographic outcomes of shoulder arthroplasty performed in patients 80 years and older. METHODS: A literature search of Embase, PubMed, Medline, and Cochrane databases was performed according to PRISMA guidelines. Studies evaluating the outcomes of primary and revision anatomic (aTSA) and reverse (RSA) total shoulder arthroplasty in patients 80 years and older were included for analysis...

INTRODUCTION: The role of the subscapularis (Ssc) tendon does not yet have a well-defined role in RSA. The purpose of the present study was to evaluate if the repair of the Ssc in RSA improves overall clinical and radiographic results and if it has the same results using a medialized design humeral stem compared to a lateralized design. METHODS: Eighty-four consecutive patients undergoing RSA were retrospectively analyzed. Nine patients were lost at FU. Two implants with similar glenosphere design and different stem design (medialized and lateralized) were used...

BACKGROUND: Rotator cuff tear size, fatty infiltration, and scapular morphology are correlated with tendon healing and functional outcomes after arthroscopic repair; however, the association between anteroposterior acromial coverage and the clinical outcomes of anteroposterior massive rotator cuff tears (AP-MRCTs; involving all 3 tendons) remains unclear. PURPOSE: To identify the association between AP acromial coverage and functional and radiological outcomes after arthroscopic repair of AP-MRCTs...

BACKGROUND: The use of reverse total shoulder arthroplasty (RSA) for the treatment of proximal humeral fractures (PHFs) is steadily increasing. Better clinical outcomes of RSA have been correlated with tuberosity reattachment and healing. The purpose of this study was to evaluate both the clinical and radiological results of reverse shoulder arthroplasty in the management of a proximal humerus fracture in the elderly. METHODS: Retrospective study including 400 consecutive 3-4 part proximal humerus fractures treated with reverse shoulder arthroplasty with a minimum of 12-month follow-up...

BACKGROUND: As techniques and implants for reverse total shoulder arthroplasty (rTSA) evolve, a greater emphasis is being placed on preserving glenoid bone stock and optimizing shoulder biomechanics. Augmented baseplates preserve glenoid bone and improve shoulder range of motion by lateralizing the center of rotation of the glenosphere, while also reducing postoperative complications after rTSA. The technique for bone preservation with use of augmented baseplates in the absence of bone loss and the outcomes of a series of cases are contained in this report...

BACKGROUND: Traumatic injuries to the chest are a frequent cause of mortality among young individuals. Imaging plays a crucial role in the management of thoracic trauma, providing essential details for accurate diagnosis and treatment. OBJECTIVE: To assess the respective contributions of radiography and CT in cases of chest trauma. SETTINGS AND DESIGN: We assessed 64 subjects, gathering findings from both CT scans and radiographic imaging...

PURPOSE: Determine whether reverse shoulder arthroplasty (RSA) glenoid baseplate tilt is influenced by surgical approach and/or associated with functional scores. METHODS: In total, 501 shoulders (483 patients) who underwent RSA, by anterosuperior (AS, n = 88) or deltopectoral (DP, n = 413) approach. Preoperative and immediate postoperative anteroposterior and scapular Y-view radiographs were used to measure: Inclination of the supraspinatus fossa's floor relative to the horizontal (Sigma angle), inclination of the glenoid fossa line (or glenoid baseplate surface) relative to the horizontal (beta-h angle) or to the supraspinatus fossa's floor (beta-s angle)...