2017 ISAKOS Biennial Congress ePoster #2121
Which Shoulder Motions Cause Subacromial Impingement? Evaluating the Vertical Displacement and Peak Strain of the Coracoacromial Ligament by Ultrasound Speckle Tracking Imaging
In Park, MD, Seoul KOREA, REPUBLIC OF
Yang-Soo Kim, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Hyo-Jin Lee, MD, Prof., Seoul KOREA, REPUBLIC OF
Hong-Ki Jin, MD, Busan KOREA, REPUBLIC OF
Dong-Hyuk Sun, MD, Seoul, Seoul KOREA, REPUBLIC OF
Sung-Ryeoll Park, MD, Seoul KOREA, REPUBLIC OF
Jin Hong Kim, MD, Seoul KOREA, REPUBLIC OF
Jong-Ho Kim, MD, Seoul KOREA, REPUBLIC OF
Dongjin Kim, MD, Seoul KOREA, REPUBLIC OF
Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
In this study, we focused on describing specific shoulder motion which actually causes shoulder impingement and showing how this impingement is described on ultrasound. Regarding the results, the patients with impingement syndrome or a repaired cuff should avoid forward flexion, horizontal abduction, and IR90 which showed higher vertical displacement and peak strain of the coracoacromial ligament
Subacromial impingement is a common cause of shoulder pain and one cause of rotator cuff disease. We aimed to identify which shoulder motions cause subacromial impingement by measuring the vertical displacement and peak strain of the coracoacromial ligament using ultrasound speckle tracking imaging.
Sixteen shoulders without shoulder disability were enrolled. All subjects were men, and the average age was 28.6 years. The vertical displacement and peak strain of the coracoacromial ligament were analyzed by the motion tracing program during the following active assisted motions (active motion controlled by the examiner): (1) forward flexion in the scapular plane, (2) horizontal abduction in the axial plane, (3) external rotation with the arm at 0° abduction (ER0), (4) internal rotation with the arm at 0° abduction (IR0), (5) internal rotation with the arm at 90° abduction (IR90), and (6) internal rotation at the back (IRB). All ultrasonographic examinations were performed with an echocardiography system (Vivid S5; GE Vingmed Ultrasound AS, Horten, Norway) by 2-dimensional speckle tracking echocardiography using a 12L-RS linear probe in harmonic mode (frequency, 6-13 MHz).
The mean vertical displacement of the coracoacromial ligament during forward flexion (2.2 mm), horizontal abduction (2.2 mm), and IR90 (2.4 mm) was significantly greater than that during the other motions (ER0, -0.7 mm; IR0, 0.5 mm; IRB, 1.0 mm; P < .003). The mean peak strain was significantly higher in forward flexion (6.88%), horizontal abduction (6.58%), and IR90 (4.88%) than with the other motions (ER0, 1.42%; IR0, 1.78%; IRB, 2.61%; P < .003).
Forward flexion, horizontal abduction, and IR90 showed higher vertical displacement and peak strain of the coracoacromial ligament, causing subacromial impingement. It is recommended that patients with impingement syndrome or a repaired rotator cuff avoid these shoulder motions.