The differences of the acromiohumeral interval between supine and upright radiographs of the shoulder

Abstract

The acromiohumeral interval (AHI) is a measurement used to determine the superior migration of the humeral head in rotator cuff (RC) tear patients. The purpose of this study was to compare the AHI of; supine, upright shoulder radiographs, and magnetic resonance imaging (MRI) of the shoulder. The 86 shoulders were divided into 3 groups that included; (1) non-full thickness tear (50%), (2) full thickness (FT) tear ≤3 cm (33.7%), and (3) FT tear > 3 cm (16.3%). The mean difference of AHI noted was significantly lower in the supine radiographs and MRIs than with the upright (1.34–1.37 mm, 1.62–1.87 mm, respectively). Upright AHI ≤ 7.0 mm had 27.9% sensitivity and 100% specificity in diagnosing FT tears with 64% accuracy (p < 0.001). The supine AHI ≤ 6.5 mm had 32.6% sensitivity, 100.0% specificity, and 66.3% accuracy (p < 0.01). The results revealed the AHI in supine radiographs were significantly lower than upright shoulder radiographs. For AHI ≤ 7 mm in upright shoulder radiographs, this remains as an appropriate diagnostic test for ruling in shoulders with full thickness rotator cuff tears. This value was not relevant for use as the cut point in the supine radiographs and MRIs.