Usefulness of computed tomography based three-dimensional reconstructions to assess the critical shoulder angle.

Autor:	Mah D; Faculty of Medicine, University of New South Wales, Sydney 2052, New South Wales, Australia., Chamoli U; Spine Service Research Group, St. George and Sutherland Clinical School, University of New South Wales, Sydney 2052, New South Wales, Australia., Smith GC; St. George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney 2217, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	World journal of orthopedics [World J Orthop] 2021 May 18; Vol. 12 (5), pp. 301-309. Date of Electronic Publication: 2021 May 18 (Print Publication: 2021).
DOI:	10.5312/wjo.v12.i5.301
Abstrakt:	Background: The critical shoulder angle (CSA) is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length. Higher values may correlate with the presence of rotator cuff tears. However, it is difficult to obtain a high-quality true anteroposterior (AP) radiograph of the shoulder, with any excess scapular version or flexion/extension resulting in deviation from the true CSA value. Three-dimensional (3D) bony reconstructions of computed tomography (CT) shoulder scans may be able to be rotated to obtain a similar view to that of true AP radiographs. Aim: To compare CSA measurements performed on 3D bony CT reconstructions, with those on corresponding true AP radiographs. Methods: CT shoulder scans were matched with true AP radiographs that were classified as either Suter-Henninger type A or C quality. 3D bony reconstructions were segmented from the CT scans, and rotated to replicate an ideal true AP view. Two observers performed CSA measurements using both CT and radiographic images. Measurements were repeated after a one week interval. Reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman plots [bias, limits of agreement (LOA)]. Results: Twenty CT shoulder scans were matched. The mean CSA values were 32.55° (± 4.26°) with radiographs and 29.82° (± 3.49°) with the CT-based method [mean difference 2.73° (± 2.86°); P < 0.001; bias +2.73°; LOA -2.17° to +7.63°]. There was a strong correlation between the two methods ( r = 0.748; P < 0.001). Intra-observer reliability was similar, but the best intra-observer values were achieved by the most experienced observer using the CT-based method [ICC: 0.983 (0.958-0.993); bias +0.03°, LOA -1.28° to +1.34°]. Inter-observer reliability was better with the CT-based method [ICC: 0.897 (0.758-0.958), bias +0.24°, LOA -2.93° to +3.41°]. Conclusion: The described CT-based method may be a suitable alternative for critical shoulder angle measurement, as it overcomes the difficulty in obtaining a true AP radiographic view. Competing Interests: Conflict-of-interest statement: We have no financial relationships to disclose. (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu