From the Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Thomas Jefferson University Hospital, Jefferson Medical College, 132 S 10th St, Philadelphia, PA 19107 (J.B.R., W.B.M., A.C.Z.); and Division of Sports Medicine, Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, Jefferson Medical College, Philadelphia, Pa (M.G.C.).
Radiology. 2015 Jan;274(1):201-9. doi: 10.1148/radiol.14140587. Epub 2014 Oct 14.
To describe the frequency of acromial apophysiolysis and its association with incomplete fusion and superior shoulder pain, to determine risk factors of acromial apophysiolysis, and to assess whether acromial apophysiolysis is associated with the development of an os acromiale and rotator cuff tears.
Institutional review board approval was obtained for this HIPAA-compliant study; requirement for informed consent was waived. A retrospective report review of 2372 consecutive patients between 15 and 25 years of age who underwent shoulder magnetic resonance (MR) imaging for shoulder pain was performed. Individuals with edema at the acromial apophyses and no other abnormalities on MR images were included in the study group. Association of acromial edema with incomplete fusion, pitching, and clinical findings was determined in the study group and in an age- and sex-matched control group, with both univariate and multivariate binary logistic regression analyses. Association with the development of an os acromiale and rotator cuff tears later in life was assessed with follow-up imaging after age 25 years.
Edema at the acromial apophyses was found in 2.6% (61 of 2372) of patients and was associated with incomplete fusion of the acromial apophyses (χ(2), P < .001) and superior shoulder tenderness (P < .001). The entity was named acromial apophysiolysis. A pitch count of more than 100 pitches per week was shown to be a risk factor for acromial apophysiolysis (odds ratio [ OR odds ratio ] = 6.5, P = .017). Follow-up imaging showed that acromial apophysiolysis was significantly associated with the development of an os acromiale ( OR odds ratio = 138, P < .001) and rotator cuff tears ( OR odds ratio = 5.4, P = .015) after age 25 years.
Acromial apophysiolysis is characterized by incomplete fusion and edema at the acromial apophyses. It is associated with superior shoulder pain in young patients (< 25 years old), and pitching is a risk factor. It predisposes the patient to the development of an os acromiale and rotator cuff tears after age 25 years.
描述肩峰骨骺分离的频率及其与不完全融合和肩部上方疼痛的关系，确定肩峰骨骺分离的危险因素，并评估肩峰骨骺分离是否与肩峰骨化和肩袖撕裂的发生有关。
本 HIPAA 合规研究获得机构审查委员会批准；豁免了知情同意的要求。对 2372 例年龄在 15 至 25 岁之间因肩部疼痛而行肩部磁共振成像（MR）检查的连续患者进行回顾性报告分析。在磁共振图像上，研究组患者存在肩峰骨骺处水肿且无其他异常，将其纳入研究组。在研究组和年龄及性别匹配的对照组中，分别进行单变量和多变量二项逻辑回归分析，确定肩峰水肿与不完全融合、投掷运动和临床发现之间的关系。通过 25 岁以后的随访影像学检查，评估肩峰骨骺分离与以后发生肩峰骨化和肩袖撕裂的关系。
在 2372 例患者中，有 2.6%（61 例）的患者存在肩峰骨骺处水肿，与肩峰骨骺不完全融合（χ²，P <.001）和肩部上方压痛（P <.001）有关。将这种情况命名为肩峰骨骺分离。每周投球次数超过 100 次被证明是肩峰骨骺分离的危险因素（比值比[OR odds ratio] = 6.5，P =.017）。随访影像学检查显示，肩峰骨骺分离与 25 岁以后发生肩峰骨化（OR odds ratio = 138，P <.001）和肩袖撕裂（OR odds ratio = 5.4，P =.015）显著相关。
肩峰骨骺分离的特征为不完全融合和肩峰骨骺处水肿。它与年轻患者（<25 岁）肩部上方疼痛有关，而投掷运动是一个危险因素。它使患者在 25 岁以后更容易发生肩峰骨化和肩袖撕裂。
