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Comparison of MRI and Conventional Radiography for Assessment of Acromial Shape

Marius E. Mayerhoefer1, Martin J. Breitenseher1, Andreas Roposch2, Christina Treitl1 and Christian Wurnig3

1 Department of Radiology, Medical University of Vienna/Austria, Waehringer Guertel 18-20, Vienna, 1090 Austria.
2 Present address: Department of Orthopedics, University of Toronto, Toronto, ON, Canada. At time of study: Medical University of Vienna, Department of Orthopaedics, Vienna, Austria.
3 Second Orthopaedic Department, Orthopaedic Hospital Vienna-Speising, Vienna, Austria.



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  		Fig. 1. —Three-dimensional reconstruction of acromion and clavicula with manually schematized acromioclavicular joint capsule (yellow), illustrating the three MRI slice positions: S-1, S-2, and S-3. S-3 already depicts most lateral part of joint capsule. Note that because of individual differences in acromial size, S-1 and S-2 are not always located directly next to each other.

 


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  		Fig. 2A. —Mathematic determination of acromial shape. Line connecting most caudal points of acromial undersurface is drawn on parasagittal T2-weighted MR image, and with help of two orthogonal lines, acromion is divided into three segments of equal length.

 


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  		Fig. 2B. —Mathematic determination of acromial shape. Then on parasagittal T2-weighted MR image, angle between anterior third and posterior two thirds is measured. In this case, anterior angle of deflection is 180° – 168° = 12°, indicating slightly curved (type 2) acromion in S-2 position.

 


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  		Fig. 3A. —41-year-old man with impingement syndrome of the shoulder. Both outlet view radiograph (A) and MR image (B) in position S-2 show flat type 1 acromion, which was also confirmed by 3D model (C) and intraoperatively.

 


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  		Fig. 3B. —41-year-old man with impingement syndrome of the shoulder. Both outlet view radiograph (A) and MR image (B) in position S-2 show flat type 1 acromion, which was also confirmed by 3D model (C) and intraoperatively.

 


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  		Fig. 3C. —41-year-old man with impingement syndrome of the shoulder. Both outlet view radiograph (A) and MR image (B) in position S-2 show flat type 1 acromion, which was also confirmed by 3D model (C) and intraoperatively.

 


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  		Fig. 4A. —47-year-old woman with impingement syndrome of shoulder. Both outlet view radiograph (A) and MR image (B) in position S-2 show curved type 2 acromion, which is also confirmed by 3D-model (C) and intraoperatively.

 


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  		Fig. 4B. —47-year-old woman with impingement syndrome of shoulder. Both outlet view radiograph (A) and MR image (B) in position S-2 show curved type 2 acromion, which is also confirmed by 3D-model (C) and intraoperatively.

 


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  		Fig. 4C. —47-year-old woman with impingement syndrome of shoulder. Both outlet view radiograph (A) and MR image (B) in position S-2 show curved type 2 acromion, which is also confirmed by 3D-model (C) and intraoperatively.

 


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  		Fig. 5A. —63-year-old man with impingement syndrome of shoulder. Whereas outlet view radiograph (A) depicts curved acromion (type 2), MR image (B) in position S-1 reveals blunt acromial hook (type 3), which is also confirmed by 3D model (C) and intraoperatively.

 


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  		Fig. 5B. —63-year-old man with impingement syndrome of shoulder. Whereas outlet view radiograph (A) depicts curved acromion (type 2), MR image (B) in position S-1 reveals blunt acromial hook (type 3), which is also confirmed by 3D model (C) and intraoperatively.

 


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  		Fig. 5C. —63-year-old man with impingement syndrome of shoulder. Whereas outlet view radiograph (A) depicts curved acromion (type 2), MR image (B) in position S-1 reveals blunt acromial hook (type 3), which is also confirmed by 3D model (C) and intraoperatively.

 

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