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Sonographic assessment of subacromial bursa distension during arm abduction: establishing a threshold value in the diagnosis of subacromial impingement syndrome

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Abstract

Purpose

In this study, we aimed to establish a quantitative threshold value in the diagnosis of subacromial impingement syndrome by measuring the thickness of the subacromial bursa during abduction and adduction.

Materials and methods

Forty-five patients with subacromial impingement syndrome and 54 healthy individuals underwent dynamic shoulder ultrasonography. The subacromial bursa, between the supraspinatus tendon margin and peribursal adipose tissue, was measured between the acromion and humeral head at its widest part. The subacromial impingement ratio was calculated by dividing the subacromial bursa thickness during abduction to the subacromial bursa thickness during adduction. Shapiro–Wilk test was used in the assessment of normal distribution of parameters.

Results

The mean subacromial bursa thickness in the abduction position was 1.8 ± 1.1 mm in the study group and 0.9 ± 0.3 mm in the control group. The mean subacromial bursa thickness in the adduction position was 0.9 ± 0.5 mm in the study group and 0.8 ± 0.3 mm in the control group. The subacromial impingement ratio showed a statistically significant difference between groups (p < 0.0001), and the ratio being 2.0 ± 0.5 in the study group and 1.2 ± 0.1 in the control group. For measurements performed in the abduction position, the best cut-off value was calculated as 1.3 mm, and sensitivity and specificity were 70.6 and 85.2%, respectively. The best cut-off value was 1.4 for the subacromial impingement ratio, and sensitivity and specificity were 88.2 and 96.3%, respectively.

Conclusion

Subacromial impingement ratio is a very practical and reliable method in subacromial impingement syndrome diagnosis.

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Author information

Authors and Affiliations

  1. Department of Radiology, SBU Adana Numune Training and Research Hospital, Ege Bagatur Bulvarı Serinevler Yüreğir, 01240, Adana, Turkey

    Gokhan Soker, Bozkurt Gulek, Omer Kaya, Muhammet Arslan & Cengiz Yilmaz

  2. Department of Physical Therapy and Rehabilitation, SBU Adana Numune Training and Research Hospital, Adana, Turkey

    Eda Soker & Derya Memis

  3. Department of Radiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey

    Ibrahim Inan

  4. Department of Radiology, Faculty of Medicine, Mersin University, Mersin, Turkey

    Kaan Esen

Authors
  1. Gokhan Soker
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  2. Bozkurt Gulek
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  4. Omer Kaya
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Correspondence to Gokhan Soker.

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The authors declare that they have no competing interests and source of funding.

Ethical statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from patients for being included in the study.

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Soker, G., Gulek, B., Soker, E. et al. Sonographic assessment of subacromial bursa distension during arm abduction: establishing a threshold value in the diagnosis of subacromial impingement syndrome. J Med Ultrasonics 45, 287–294 (2018). https://doi.org/10.1007/s10396-017-0839-9

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  • DOI: https://doi.org/10.1007/s10396-017-0839-9

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