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. 2022 May 9;11(9):2661.
doi: 10.3390/jcm11092661.

Coracoid Impingement and Morphology Is Associated with Fatty Infiltration and Rotator Cuff Tears

Saadiq F El-Amin 3rd  1   2   3 , Nicola Maffulli  4   5   6   7 , Matthew C Mai  8 , Hugo C Rodriguez  9   10 , Victoria Jaso  11 , Dylan Cannon  9 , Ashim Gupta  3   12   13   14
Affiliations

Coracoid Impingement and Morphology Is Associated with Fatty Infiltration and Rotator Cuff Tears

Saadiq F El-Amin 3rd et al. J Clin Med. .

Abstract

This study describes measurements between the coracoid, glenoid, and humerus; characterizes coracoid shape, rotator cuff fatty infiltration, and quantitatively evaluates coracoid impingement and its association with anterosuperior rotator cuff tears (ASCT). 193 shoulder magnetic resonance imaging (MRI) scans demonstrating: rotator cuff tear; isolated tear of the supraspinatus; tear of supraspinatus and subscapularis, were included. MRI measurements included coracohumeral interval (CHI), coracoid overlap (CO), coracoid recess (CR), coracoglenoid angle (CGA), and coracoglenoid interval (CGI) on axial slices; acromiohumeral interval (AHI) on coronal slices; and coracohumeral interval (CHI) and coracoacromial ligament (CAL) thickness on sagittal slices. The coracoid shape was classified as flat, curved, or hooked. An Independent T-test was used to compare the MRI measurements and the different rotator cuff tear groups. In 79% of the patients with ASCT tears, the coracoid was curved. Axial CHI, CGA, sagittal CHI, and AHI were decreased in ASCT when compared to no tears and isolated supraspinatus tears (p < 0.05). CO was increased in ASCT compared to no tears and isolated supraspinatus tears (p < 0.05). Patients with an ASCT had a significantly increased subscapularis and supraspinatus Goutallier fatty infiltration score when compared to no tear and isolated supraspinatus tears (p < 0.05). These quantitative measurements may be useful in identifying patients at risk for ASCT. Level of Evidence III.

Keywords: anterosuperior cuff tear; coracoid impingement; coracoid morphology; magnetic resonance imaging; rotator cuff fatty infiltration; supraspinatus tear.

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Conflict of interest statement

S.F.E.-A.III and A.G. have industrial affiliations, however, there are no conflicts of interest with the work presented in this manuscript. Thus, S.F.E.-A.III and A.G. declare no conflicts of interest. Other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart indicating the inclusion of MRI images.
Figure 2
Figure 2
(A) Line A: the reference line drawn parallel to the glenoid on axial MRI of the shoulder. Line B: coracohumeral distance measured as the closest distance between coracoid and humerus with a line parallel to line A. Line C: coracoid overlap. Line D: coracoid recess. (B) Axial MRI of shoulder showing coracohumeral interval, Line E, and coracoglenoid angle (Angle F).
Figure 3
Figure 3
(A) Coronal MRI of shoulder showing measurement of coronal acromiohumeral interval (AHI). (B) Sagittal MRI of shoulder showing coracohumeral interval (CHI).
Figure 4
Figure 4
Sagittal MRI of shoulder showing measurement of coracoacromial ligament (CAL).
Figure 5
Figure 5
Coracoid Morphology on axial MRI of shoulder: (A) Curved; (B) Hook; (C) Flat.
Figure 6
Figure 6
Quantitative MRI measurements in relation to the presence of tears. CR = coracoid recess, CO = coracoid overlap, CHI = coracohumeral interval, CGI = coracoglenoid interval, CAL = coracohumeral thickness and AHI = acromiohumeral interval. * demonstrates statistically significant difference (p < 0.05) between ASCT vs no tear group; ‡ demonstrates statistically significant (p < 0.05) difference between ASCT vs supraspinatus group.
Figure 7
Figure 7
Goutallier fatty infiltration score in relation to rotator cuff tears. ASCT = Anterosuperior Cuff Tear. *, ‡ and Ω demonstrates statistically significant differences (p < 0.001) between supraspinatus tear vs no tear in supraspinatus group, between ASCT vs no tear, and ASCT vs supraspinatus tear.
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