Key result
The coracoid-humeral distance on MRI demonstrated high diagnostic accuracy for subcoracoid impingement syndrome with an AUC of 0.963, which significantly increased to 0.986 when combined with the height of the lesser tuberosity.
Why the study?
The study aimed to identify diagnostic MRI findings in shoulders with subcoracoid impingement syndrome compared to normal shoulders.
Do specific MRI parameters accurately diagnose subcoracoid impingement syndrome compared to normal shoulders?
Case-Control (n=147)
No
Do specific MRI parameters accurately diagnose subcoracoid impingement syndrome compared to normal shoulders?
Effect estimate: AUC 0.963
Measurement of the coracoid-humeral distance and height of the lesser tuberosity on MRI provides high diagnostic accuracy for subcoracoid impingement syndrome.
May aid subcoracoid impingement diagnosis on MRI; leaves open prospective validation before clinical use.
BACKGROUND The aim of this study was to identify the diagnostic magnetic resonance imaging (MRI) findings in 47 shoulders with subcoracoid impingement syndrome by comparison with 100 normal shoulders. MATERIAL AND METHODS The subcoracoid impingement syndrome group consisted of 47 shoulders with subcoracoid impingement syndrome and the normal group consisted of 100 normal shoulders. The MRI parameters - coracoids-humeral distance (CHD), coracoid index (CI), height of the lesser tuberosity (HLT), coracoid obliquity (CO), coracoglenoid angle (CGA), coracohumeral angle (CHA), width of the subscapular tendon (WST), and contact distance between subscapular tendon and coracoid process (CD) - were compared between the subcoracoid impingement syndrome group and the normal group. The areas under the curves (AUCs) from the receiver operating characteristic (ROC) for single MRI parameters were recorded, in which the MRI parameters with AUC exceeding 0.70 were included in the analysis of combined parameters. Comparisons of ROC were made among single parameters and combined parameters. RESULTS For diagnosing subcoracoid impingement syndrome by using single MRI parameters (CHD, CI, HLT, CGA, CHA, WST, and CD), the AUCs were 0.963, 0.806, 0.745, 0.691, 0.613, 0.685, and 0.614, respectively, of which CHD had the largest AUC. CHD, CI, and HLT (AUC exceeding 0.70) were included in the study of the combined parameters. The AUC of combined CHD and HLT showed a significantly larger AUC than that of CHD (0.986 vs 0.963, P=0.036), and showed no significant difference compared with that of combined CHD, CI, and HLT (0.986 vs 0.987, P=0.882). CONCLUSIONS Measurement of the coracoid-humeral distance and height of the lesser tuberosity were key MRI diagnostic findings for subcoracoid impingement syndrome.
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Yu et al. (2022) conducted a case-control in Subcoracoid impingement syndrome (n=147). Coracoid-humeral distance (CHD) and height of the lesser tuberosity (HLT) on MRI vs. Normal shoulders was evaluated on Diagnostic accuracy (Area Under the Curve) of coracoid-humeral distance (CHD) for subcoracoid impingement syndrome (AUC 0.963). The coracoid-humeral distance on MRI demonstrated high diagnostic accuracy for subcoracoid impingement syndrome with an AUC of 0.963, which significantly increased to 0.986 when combined with the height of the lesser tuberosity.
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