Ali Maslah Idiris, Chen Yuan-Quan, Xing-Hao Deng, Yang Yi-Tao, Heile Daha Osman, Ahmed Ayoub Hussein, Hou Jing-Yi, Long Yi, Yang Rui
Department of Orthopedic Surgery, Sport Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang Road West, Guangzhou, Guangdong Province, 510120, People's Republic of China.
Department of medical imaging & Nuclear medicine, Kamil Diagnostic Center, Mogadishu, Benadir Province, Somalia.
BMC Musculoskelet Disord. 2024 Dec 6;25(1):1003. doi: 10.1186/s12891-024-08072-y.
Previous research has established connections between the acromion index (AI), critical shoulder angle (CSA), acromiohumeral distance (AHD), and lateral acromion angle (LAA) with the incidence of rotator cuff tears (RCTs). Despite numerous international studies exploring the variability of shoulder joint morphology and parameters, research incorporating these parameters has yet to be conducted in Somalia. This study aims to analyze and describe the radiological parameters of acromion morphology in the Somali populations. Furthermore, to investigate the relationship of these parameters with rotator cuff tears within the Somali population.
The data and physical examination of 188 patients who had a CT scan of the shoulder from 2018 to 2023 were retrospective analyses, including 107 patients (49 females, 58 males) with RCT and 81 patients (20 females, 61 males) with non-RCT. Using Three-dimensional computed tomography (3D-CT), parameters such as the AI, CSA, AHD, and LAA were compared between the RCT and non-RCT groups. Two independent assessors measured Each parameter from anterior views of the scapula. The inter- and intra-observer reliability was evaluated using the intraclass correlation coefficient (ICC). Additionally, the relationship between these parameters and the presence of rotator cuff tears was explored, and the predictive value of each parameter was assessed through receiver operating characteristic (ROC) analysis.
The results showed excellent intra- and inter-observer reliability, with all ICC values above 0.75. Among these, the CSA exhibited the greatest measurement stability, with an intra-observer ICC of 0.929 and an inter-observer ICC of 0.911. Significant positive correlations were identified between the AI, CSA, and the presence of RCTs, with CSA exhibiting the strongest correlation (r = 0.629; P < 0.001). Additionally, significant negative correlations were found between the presence of RCTs and both AHD (-0.247) and LAA (-0.338; P < 0.001 for both). The ROC analysis revealed that the CSA is the most effective parameter for identifying the presence of RCT (area under the ROC curve. 0.857).
The outcome of this study shows that AI, CSA, AHD, and LAA are independent factors associated with rotator cuff tears in the East African, particularly the Somali population. Specifically, larger AI, CSA, and smaller AHD and LAA are correlated with an increased likelihood of RCTs in this population. In patients with shoulder disease suspected of RCTs, using a 3D-CT scan to measure the CSA may be helpful, as it is the best predictor measurement.
Not Applicable.
先前的研究已经确立了肩峰指数（AI）、临界肩角（CSA）、肩峰肱骨头距离（AHD）和肩峰外侧角（LAA）与肩袖撕裂（RCT）发生率之间的联系。尽管有大量国际研究探讨了肩关节形态和参数的变异性，但在索马里尚未开展纳入这些参数的研究。本研究旨在分析和描述索马里人群肩峰形态的放射学参数。此外，调查这些参数与索马里人群肩袖撕裂之间的关系。
对2018年至2023年期间接受肩部CT扫描的188例患者的数据和体格检查进行回顾性分析，包括107例肩袖撕裂患者（49例女性，58例男性）和81例无肩袖撕裂患者（20例女性，61例男性）。使用三维计算机断层扫描（3D-CT），比较肩袖撕裂组和无肩袖撕裂组之间的AI、CSA、AHD和LAA等参数。两名独立评估者从肩胛骨前视图测量每个参数。使用组内相关系数（ICC）评估观察者间和观察者内的可靠性。此外，探讨这些参数与肩袖撕裂存在之间的关系，并通过受试者工作特征（ROC）分析评估每个参数的预测价值。
结果显示观察者内和观察者间具有出色的可靠性，所有ICC值均高于0.75。其中，CSA表现出最大的测量稳定性，观察者内ICC为0.929，观察者间ICC为0.911。AI、CSA与肩袖撕裂的存在之间存在显著正相关，CSA表现出最强的相关性（r = 0.629；P < 0.001）。此外，肩袖撕裂的存在与AHD（-0.247）和LAA（-0.338；两者P < 0.001）均存在显著负相关。ROC分析显示，CSA是识别肩袖撕裂存在的最有效参数（ROC曲线下面积为0.857）。
本研究结果表明，AI、CSA、AHD和LAA是与东非，特别是索马里人群肩袖撕裂相关的独立因素。具体而言，在该人群中，较大的AI、CSA以及较小的AHD和LAA与肩袖撕裂的可能性增加相关。在怀疑有肩袖撕裂的肩部疾病患者中，使用3D-CT扫描测量CSA可能会有所帮助，因为它是最佳的预测性测量指标。
不适用。
