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Is the lateral extension of the acromion related to the outcome of shoulder injections?

Dietrich, Tobias ; Moor, Beat ; Puskas, Gabor ; Pfirrmann, Christian ; Hodler, Juerg ; Peterson, Cynthia

In: European Radiology, 2015, vol. 25, no. 1, p. 267-273

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    Titre
    • Is the lateral extension of the acromion related to the outcome of shoulder injections?
    Auteur
    • Dietrich, Tobias. Orthopedic University Hospital Balgrist, University of Zurich, Faculty of Medicine, Forchstrasse 340, 8008, Zurich, Switzerland
    • Moor, Beat. Orthopedic University Hospital Balgrist, University of Zurich, Faculty of Medicine, Forchstrasse 340, 8008, Zurich, Switzerland
    • Puskas, Gabor. Orthopedic University Hospital Balgrist, University of Zurich, Faculty of Medicine, Forchstrasse 340, 8008, Zurich, Switzerland
    • Pfirrmann, Christian. Orthopedic University Hospital Balgrist, University of Zurich, Faculty of Medicine, Forchstrasse 340, 8008, Zurich, Switzerland
    • Hodler, Juerg. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Faculty of Medicine, Raemistrasse 100, 8091, Zurich, Switzerland
    • Peterson, Cynthia. Orthopedic University Hospital Balgrist, University of Zurich, Faculty of Medicine, Forchstrasse 340, 8008, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • European Radiology, 2015, vol. 25, no. 1, p. 267-273. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331449
    Summary
    Objective: To assess patients' outcomes after subacromial or glenohumeral injections based on the degree of lateral extension of the acromion. Methods: 307 patients were prospectively included after therapeutic fluoroscopy-guided subacromial (n = 148) or glenohumeral (n = 159) injections with anaesthetic and long-acting corticosteroids. Pre- and post-injection outcomes at 1week and 1month were obtained using the 11-point numerical rating scale (NRS) for pain. Lateral extension of the acromion was quantified and categorized by the critical shoulder angle (CSA) and the acromion index (AI) on anteroposterior conventional radiographs. Results: Patients' outcomes at 1week and 1month were significantly improved (p < 0.001) compared to baseline for subacromial and glenohumeral injection patients. Patients with a CSA <35° showed significantly higher pain reduction 1month after subacromial injection compared to patients with a CSA >35° (4.2 ± 2.6 vs. 3.2 ± 3.0, p = 0.04). A significant difference in the 1-month NRS change in pain scores is noted for smaller AIs after subacromial injection (4.3 ± 2.8 vs. 2.6 ± 2.9; p = 0.01). No significant association was noted between clinical outcome and the lateral extension of the acromion after glenohumeral joint injections. Conclusions: A short lateral extension of the acromion was associated with better clinical outcomes in subacromial injection patients but not in glenohumeral injection patients. Key Points : • Patients' outcomes at 1month improved significantly compared to baseline for subacromial injections •Patients' outcomes at 1month improved significantly compared to baseline for glenohumeral injections •Short acromial lateralization was associated with better clinical outcome after subacromial injection •The acromial lateralization was not associated with clinical outcome after glenohumeral injection