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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Significant Association Between Snapping Scapula Syndrome and Anterior Angulation of the Superomedial Scapular Angle
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Significant Association Between Snapping Scapula Syndrome and Anterior Angulation of the Superomedial Scapular Angle

机译：肩S骨综合征与肩om上肩Angle角前角之间的重要联系

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Objectives: Significant Association Between Snapping Scapula Syndrome and Anterior Angulation of the Superomedial Scapular Angle. Methods: In this Institutional Review Board approved study, bony morphologies of the scapula were evaluated on the MRIs of 28 patients (28 scapulae) with SSS and 20 patients (22 scapulae) with non-SSS pathologies. Patients with SSS were identified from a prospective surgical registry that had undergone a preoperative shoulder MRI along with scapular bursectomy and/or superomedial angle resection. The non-SSS patients underwent shoulder MRIs for other reasons that subsequently allowed for evaluation of the scapula. The medial scapula corpus angle (MSCA), was measured on axial STIR or PD FSE sequences cranial to the spine of the scapula (Figure 1). Scapula length angled towards rib cage was documented. Scapulae were categorized as straight, s-shaped or concave. Two blinded observers, one radiologist and one orthopedic surgeon, reviewed all MRIs. MSCAs were measured using Stryker OfficePACS Power 4.1 Express Edition (Kalamazoo, MI). Positive MSCAs were defined as anterior scapular angulation towards the thorax in the axial plane whereas negative MSCAs were defined as posterior scapular angulation away from the thorax in the axial plane. Results: Axial scapula corpus configurations were identified: 31 scapulae were of the straight type, 14 were s-shaped and 5 were concave. All five concave scapulae had surgically confirmed SSS. The measurement of MSCA had excellent inter-observer agreement of 0.81 [95% CI, 0.68 to 0.89] and a fair to good intra-observer agreement of 0.68 [95% CI, 0.50 to 0.80]. There were significant differences in the mean MSCAs between those with SSS (14.4° ± 19.3°) and those with other pathologies (-3.3° ± 15.3°; p = 0.001). After excluding all concave scapulae (n = 5), the differences in the mean MSCAs between the SSS and non-SSS groups were significant (MSCA for SSS: 15.3° ± 17.5° MSCA for non-SSS: -3.3° ± 15.3°; p < 0.0001). Twenty of 28 (71.4%) scapulae with a positive MSCA had SSS, whereas only 3 of 17 (25%) scapulae with a negative MSCA had SSS (see Figure 1). The mean length of the medial scapula border angled to towards the rib cage was 14.4 mm (± 4.6 mm). Conclusion: Anterior angulation of the superomedial angle in the axial plane had an association with SSS. Those patients with a concave-shaped scapula and a positive MSCA may be at risk for SSS. This information may have clinical relevance in the treatment of SSS patients since there are no guidelines on the amount of scapular resection may or may not be needed. The MSCA may prove helpful in determining the location and amount of scapula resection needed to reduce SSS symptoms in patients.
机译：目的：肩S骨综合征和肩om上角前倾角之间的显着关联。方法：在该机构审查委员会批准的研究中，通过对28例SSS患者（28例肩骨）和20例非SSS疾病（22例肩骨）的MRI进行评估，评估了肩骨的骨形态。从前瞻性手术登记中识别出SSS的患者，该手术已经接受了术前肩部MRI以及肩cap囊切除术和/或肩om上角膜切除术。非SSS患者由于其他原因接受了肩部MRI检查，随后可以评估肩cap骨。内侧肩cap骨角（MSCA）是在颅骨到肩cap骨脊柱的轴向STIR或PD FSE序列上测量的（图1）。与肩cage骨成一定角度的肩cap骨长度被记录下来。肩骨分为直形，S形或凹形。两名不知情的观察员，一名放射科医生和一名骨科外科医生对所有MRI进行了检查。使用Stryker OfficePACS Power 4.1 Express Edition（密歇根州卡拉马祖）测量MSCA。阳性MSCA定义为在轴向平面中朝向胸廓的前肩terior骨成角度，而阴性MSCA定义为在轴向平面中远离胸廓的肩cap后角。结果：确定了肩骨体形态：直形肩31骨31例，S形肩14骨14例，凹形肩5骨5例。所有五个凹肩骨均经手术证实为SSS。 MSCA的测量具有优异的观察者内部一致性，为0.81 [95％CI，0.68至0.89]，公平到良好的观察者内部一致性为0.68 [95％CI，0.50至0.80]。患有SSS的患者（14.4°±19.3°）与患有其他病变的患者（-3.3°±15.3°; p = 0.001）的平均MSCA有显着差异。排除所有凹状肩骨（n = 5）后，SSS组和非SSS组之间的平均MSCA差异显着（SSS的MSCA：15.3°±17.5°;非SSS的MSCA：-3.3°±15.3°; p <0.0001）。 MSCA阳性的28个肩cap骨中有20个（71.4％）具有SSS，而MSCA阴性的17个肩25骨中有20个（25％）具有SSS（见图1）。与肩cage骨成角度的内侧肩cap骨边界的平均长度为14.4 mm（±4.6 mm）。结论：轴向上角膜的前角与SSS有关。那些具有凹形肩骨和MSCA阳性的患者可能有SSS的风险。该信息可能对SSS患者的治疗具有临床意义，因为对于肩guidelines骨切除术的数量没有指导原则，可能需要也可能不需要。 MSCA可能有助于确定减轻患者SSS症状所需的肩骨切除术的位置和数量。

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