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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 2, pp 363–369 | Cite as

Supraspinatus tendon and subacromial space parameters measured on ultrasonographic imaging in subacromial impingement syndrome

  • Lori A. MichenerEmail author
  • Sevgi S. Subasi Yesilyaprak
  • Amee L. Seitz
  • Mark K. Timmons
  • Matthew K. Walsworth
Shoulder

Abstract

Purpose

To characterize the supraspinatus tendon thickness, subacromial space, and the relationship between tendon thickness and subacromial space to further elucidate the mechanisms of subacromial impingement syndrome.

Methods

In a single-blind cross-sectional study, subjects were recruited with subacromial impingement syndrome (n = 20) and asymptomatic controls (n = 20) matched for age, gender, and hand dominance. Ultrasound images were collected using a 4–12-MHz linear transducer in B-mode of the supraspinatus tendon in the transverse (short axis) and the anterior aspect of the subacromial space outlet. Using image callipers, measurements of tendon thickness were taken at 3 points along the tendon and averaged for a single thickness measure. The subacromial space outlet was measured via the acromiohumeral distance (AHD) defined by the inferior acromion and superior humeral head. The occupation ratio was calculated as the tendon thickness as a percentage of AHD.

Results

The subacromial impingement syndrome group had a significantly thicker tendon (mean difference = 0.6 mm, p = 0.048) and a greater tendon occupation ratio (mean difference = 7.5 %, p = 0.014) compared to matched controls. There were no AHD group differences.

Conclusions

The supraspinatus tendon was thicker and occupied a greater percentage of AHD, supporting an intrinsic mechanism. An extrinsic mechanism of tendon compression is theoretically supported, but future imaging studies need to confirm direct compression with elevation. Treatment to reduce tendon thickness may reduce symptoms, and surgical intervention to increase subacromial space may be considered if tendon compression can be verified.

Keywords

Rotator cuff disease Impingement syndrome Shoulder Tendon Subacromial space 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lori A. Michener
    • 1
    Email author
  • Sevgi S. Subasi Yesilyaprak
    • 2
  • Amee L. Seitz
    • 3
  • Mark K. Timmons
    • 1
  • Matthew K. Walsworth
    • 4
  1. 1.COOR Laboratory, Department of Physical TherapyVirginia Commonwealth UniversityRichmondUSA
  2. 2.School of Physical Therapy and RehabilitationDokuz Eylül UniversityIzmirTurkey
  3. 3.Physical Therapy Department, Bouve College of Health ScienceNortheastern UniversityBostonUSA
  4. 4.Department of RadiologyUniversity of California Los AngelesLos AngelesUSA

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