ABSTRACT
Suprascapular nerve entrapment (SNE) syndrome is a commonly overlooked cause of shoulder weakness and pain. It frequently causes weakness over the posterior and lateral and posterior aspects of the shoulder, as well as pain of infraspinatus muscles. Therefore, we considered that the infraspinatus muscle cross-sectional area (IMCSA) might be a new morphological parameter to analyze SNE syndrome. We assumed that the IMCSA is an important morphologic parameter in SNE syndrome diagnosis. We acquired infraspinatus muscle data from 10 patients with SNE syndrome and from 10 healthy subjects who had undergone magnetic resonance imaging of the shoulder and who revealed no evidence of SNE syndrome. We analyzed the infraspinatus muscle thickness (IMT) and IMCSA at the shoulder on the imaging of the shoulder using our image analysis program. The IMCSA was measured as the whole infraspinatus muscle cross-sectional area that was most atrophied in the sagittal S-MR images. The IMT was measured as the thickest level of infraspinatus muscle. The mean IMT was 29.17â ±â 2.81 mm in the healthy subjects and 25.22â ±â 3.19 mm in the SNE syndrome group. The mean IMCSA was 1321.95â ±â 175.91 mm2 in the healthy group and 1048.38â ±â 259.94 mm2 in the SNE syndrome group. SNE syndrome patients had significantly lower IMT (Pâ <â .001) and IMCSA (Pâ <â .001) than the healthy group. The ROC curve shows that the optimal cutoff point of the IMT was 26.74 mm, with 70.0% sensitivity, 70.0% specificity, and an AUC of 0.83 (95% CI, 0.65-1.00). The best cutoff value of the IMCSA was 1151.02 mm2, with 80.0% sensitivity, 80.0% specificity, and AUC of 0.87 (95% CI, 0.69-1.00). The IMT and IMCSA were both significantly associated with SNE syndrome. And the IMCSA was a highly sensitive diagnostic tool.
Subject(s)
Magnetic Resonance Imaging , Nerve Compression Syndromes , Humans , Male , Female , Magnetic Resonance Imaging/methods , Nerve Compression Syndromes/diagnostic imaging , Middle Aged , Adult , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/innervation , Muscle, Skeletal/pathology , Shoulder/diagnostic imaging , Shoulder/innervation , Aged , Case-Control StudiesABSTRACT
Glenohumeral joint (GHJ) space narrowing has been demonstrated to be an important morphologic parameter of glenohumeral osteoarthritis (GHO). However, the morphology of GHJ space is irregular because of degeneration of subchondral bone and articular cartilage. Thus, we devised GHJ cartilage cross-sectional area (GHJCCSA) as a new diagnostic morphological parameter to assess the irregular morphologic change of GHJ. GHJ samples were acquired from 33 patients with GHO and from 33 normal controls without evidence of GHO based on shoulder magnetic resonance imaging. T2-weighted coronal MRIs were collected at the GHJ level for all individuals. GHJCCSA and GHJ cartilage thickness (GHJCT) at the GHJ were measured on MRIs using a graphic measuring system. The GHJCCSA was measured as the whole cartilage cross-sectional area of the GHJ. The average GHJCCSA was 115.28â ±â 17.36 mm2 in normal individuals and 61.77â ±â 13.74 mm2 in the GHO group. The mean GHJCT was 2.06â ±â 0.35 mm in normal individuals and 1.50â ±â 0.28 mm in the GHO group. GHO patients had significantly lower GHJCCSA (Pâ <â .001) and GHJCT (Pâ <â .001) than normal individuals. Receiver operator characteristics curve analysis revealed that the optimal cutoff score of the GHJCCSA was 82.21 mm2, with a sensitivity of 97.0%, a specificity of 97.0%, and an area under the curve of 0.99 (95% CI: 0.97-1.00). Although GHJCCSA and GHJCT were both significantly associated with GHO, the GHJCCSA was a more sensitive measurement parameter.
Subject(s)
Cartilage, Articular , Osteoarthritis , Shoulder Joint , Humans , Shoulder Joint/diagnostic imaging , Osteoarthritis/diagnostic imaging , Cartilage, Articular/diagnostic imagingABSTRACT
A narrowed sacroiliac joint (SIJ) space has been considered to be a major morphologic parameter of ankylosing spondylitis (AS). Previous studies revealed that the sacroiliac joint thickness (SIJT) correlated with AS in patients. However, irregular narrowing is different from thickness. Thus, we devised a method using the sacroiliac joint cross-sectional area (SIJA) as a new morphological parameter for use in evaluating AS. We hypothesized that the SIJA is a key morphologic parameter in diagnosing AS. SIJ samples were collected from 107 patients with AS, and from 85 control subjects who underwent SIJ-view X-rays that revealed no evidence of AS. We measured the SIJT and SIJA at the SIJ margin on X-rays using our picture archiving and communications system. The SIJT was measured at the narrowest point between the sacrum and the ilium. The SIJA was measured as the entire cross-sectional joint space area of the SIJ in the X-ray images. The average SIJT was 3.09â ±â 0.61 mm in the control group, and 1.59â ±â 0.52 mm in the AS group. The average SIJA was 166.74â ±â 39.98 mm2 in the control group, and 68.65â ±â 24.11 mm2 in the AS group. AS patients had significantly lower SIJT (Pâ <â .001) and SIJA (Pâ <â .001) than the control subjects. Receiver operating characteristics curve analysis showed that the best cutoff point for the SIJT was 2.33 mm, with 92.5% sensitivity, 94.1% specificity, and an area under the curve of 0.97 (95% confidence interval: 0.95-0.99). The optimal cutoff point for the SIJA was 106.19 mm2, with 93.5% sensitivity, 95.3% specificity, and an area under the curve of 0.98 (95% confidence interval: 0.97-1.00). Although the SIJT and SIJA were both significantly associated with AS, the SIJA parameter was a more sensitive measurement. We concluded that the SIJA is an easy-to-use, fast, cheap, and useful new morphological parameter for predicting AS.