Can acromiohumeral distance difference predict rotator cuff lesion? A study among unilateral shoulder pain in Makassar

Abstract

Background: Magnetic resonance imaging (MRI) is the gold standard for detecting rotator cuff injury. Simple X-ray measurement such as acromiohumeral distance (AHD) could be helpful in places where MRI is not available, in determining the possibility of rotator cuff injury. AHD is mainly genetically determined, rather than adaptively. Objective: The objective of the study was to prove the correlation of AHD difference between symptomatic and asymptomatic shoulder with rotator cuff lesion in MRI among unilateral shoulder pain in Makassar and to measure sensitivity and specificity of AHD difference in diagnosing rotator cuff tear. Materials and Methods: This is a cross-sectional controlled study. 30 patients with unilateral shoulder pain, motion range deficit, age 45–65 year old, were included in this study. Chest anteroposterior (AP) X-ray was taken, AHD difference was measured. MRI of the symptomatic shoulder was taken to confirm rotator cuff lesion. Chest AP X-ray also was taken from healthy subject for significance comparison. Statistical analysis was conducted using Spearman’s test, independent sample t-test and receiver operating characteristic curve. Result: AHD difference correlates positively with the presence of rotator cuff lesion in MRI among unilateral shoulder pain (coefficient 0.749 [P < 0.05]). AHD difference 1.05 mm detects at least partial supraspinatus tear with sensitivity 85.7 % and specificity 88.9%. AHD difference 1.75 mm detects a total supraspinatus tear with sensitivity 80% and specificity 90%. Conclusion: AHD difference on X-ray correlates with rotator cuff tear seen in MRI, and be considered as a diagnostic aid in places where MRI is not available.