Use of Radiographic Criteria for Proximal Humeral Head Migration After Dislocation of the Shoulder to Identify Damage to Its Rotator Cuff

Abstract

Objective. To assess whether radiographic criteria for proximal humeral head migration can be used as screening of damage to the rotator cuff after dislocation in patients over 45 years of age.Material and methods. The study included the results of a follow-up of 101 patients after shoulder dislocation without signs of damage to the rotator cuff before injury. Damage to the rotator cuff was assessed using MRI, followed by a correlation analysis between the results of measuring the height of the subacromial space with radiography and MRI.Results. Signs of cranial migration of the humeral head are detected statistically significantly more frequently in the group of older patients than in that of young ones (F=0.009; p<0.05). MRI study statistically significantly more often revealed signs of damage to the rotator cuff in the older patients than in the young ones (F=0.009; p<0.05). There was a high correlation between the humeral head migration index and the MRI measurements of the acromiohumeral interval (r=0.93, p<0.05).Conclusion. The acromiohumeral index, as well as MRI, can be used as a criterion for rotator cuff injury. This study has shown that the older patients have a 19-fold higher risk for damage to the rotator cuff from a dislocated shoulder (95% CI 6.93–52.11). Thus, attention should be paid to the presence of radiographic signs of rotator cuff injury in all patients after dislocation of the shoulder.

Keywords

• shoulder dislocation
• shoulder joint
• rotator cuff
• acromiohumeral index
• subacromial space
• radiography