In vivo three-dimensional motion analysis of the shoulder joint during internal and external rotation

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The purpose of this study was to assess accurately the three-dimensional movements of the scapula and humerus relative to the thorax during internal/external rotation motion with abduction of the shoulder joint.


Ten right shoulders of ten healthy volunteers were examined using a wide-gantry open magnetic resonance imaging (MRI) system. MRI was performed every 30° from 90° external rotation to 90° internal rotation of the shoulder joint.


The contribution ratio of the scapulothoracic joint was 12.5% about the long axis of the humerus during internal/external rotation motion. With arm position changes from 90° external rotation to 60° internal rotation, most movement was performed by the glenohumeral joint. Conversely, at internal rotation of ≥60°, the scapula began to markedly tilt in the anterior direction. At 90° internal rotation, the scapula was significantly tilted anteriorly (p < 0.05) when compared with the other positions.


We clarified the existence of a specific scapulohumeral motion pattern, whereby the glenohumeral joint moves with internal rotation and the scapulothoracic joint moves with anterior tilt together with internal rotation motion of the shoulder joint.

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We wish to thank Mr. Y. Sakaguchi, a radiological technologist, for performing MRI at Matsumoto medical clinic and Mr. R. Nakao, a programmer, for developing the software.

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Correspondence to Hayato Koishi.

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Koishi, H., Goto, A., Tanaka, M. et al. In vivo three-dimensional motion analysis of the shoulder joint during internal and external rotation. International Orthopaedics (SICOT) 35, 1503–1509 (2011).

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  • Internal Rotation
  • External Rotation
  • Neutral Position
  • Shoulder Joint
  • Contribution Ratio