European Journal of Anatomy

Official Journal of The Spanish Society of Anatomy
Cover Volume 22 - Number 1
Eur J Anat, 22 (1): 59-66 (2018)

A radiographic review of the subacromial architecture: a South African study

Nerissa Naidoo1, Lelika Lazarus2, Alexander Van Tongel3, Shameem A. Osman4, Kapil S. Satyapal2

1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates, 2Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa, 3Department of Physical Medicine and Orthopaedic Surgery, Ghent University, Ghent, Belgium, 4Orthopaedics, Suite 11 Medical Centre East, Life Entabeni Hospital, Durban, South Africa

ABSTRACT The subacromial space, which is occupied by the subacromial bursa, rotator cuff complex and the long head of the biceps brachii tendon, is a well-known area of study due to its association with subacromial disease. Although it is demarcated by the coraco-acromial arch and the supraglenoid tubercle, degenerative changes in these osteological components often lead to mechanical narrowing and subsequent tendon abrasion. In addition to the morphological characteristics, the morphometry of the subacromial architecture is considered to play an important role in maintaining glenohumeral stability. Accordingly, the present study outlined the morphometry of the subacromial architecture and the acromial morphology from a radiological perspective.A total of 120 true lateral-outlet view radiographs (n = 120), representative of 58 males and 62 females of the Black (12), Coloured (10), Indian (27) and White (71) race groups, were analysed. In addition to calculation of the standard and population-specific means, the acromial classification scheme of Bigliani et al. (1986) was adopted. A trend of ascending values from Type III (16.7%) to Type II (37.5%) to Type I (45.8%) acromia was noted. Various shapes of the subacromial space were observed, viz. rhomboidal (20.0%), trapezoidal (65.8%) and triangular (14.1%). Since a statistically significant P value of 0.030 was recorded for the comparison of acromial type with the shape of the subacromial space, the shape of the subacromial space appeared to be dependent on the acromial type. While the parameters were determined with regard to the demographic representation of South Africa, this study also provided standard mean values which were not previously reported. Furthermore, the correlation of the acromio-glenoidal length with side, gender and shape of the subacromial space reflected levels of significance and highlighted this parameter as a diagnostic determinant of subacromial disease due to its tendency to change in accordance with the demographic and morphological factors.

Keywords: Subacromial architecture Acromial type Patient demographics Subacromial disease

European Journal of anatomy
ISSN 2340-311X (Online)