Bilateral Arm-Abduction Shoulder Radiography to Determine the Involvement of the Scapulothoracic Motion in Frozen Shoulder

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedic Surgery, Renmin Hospital of Wuhan University, Wuhan, China

2 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Shahid Kamyab Emdadi Hospital, Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Traumatology , Hand and Orthopedic Surgery Department, st. Marien Medical Campus, Friesoythe, Germany

5 Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

Abstract

 
Background: We hypothesize that there is no difference in the motion of the scapula with respect to the thoracic wall (scapulothoracic interface) between the affected versus non-affected shoulder on 0° and 90° standard arm abduction radiography.
Methods: We enrolled 30 patients with the diagnosis of unilateral frozen shoulder after ruling out of other pathologies. Bilateral standard shoulder radiography was done in two position of 0° and 90° of arm abduction. Non-affected side was used as a control group.
Results: The mean scapulothoracic angle of the affected side was significantly larger than the non-affected side in both 0° and 90°of abduction in spite that the scapulohumeral angles were comparable in 0°, indicating potential alteration in scapular positioning.
Conclusion: Scapulothoracic motion and position can be affected in frozen shoulder along with other areas. All treatment modalities should be applied to this area as well if substantial difference was detected between the two sides.
Level of evidence: I

Keywords

Main Subjects


1. Ebrahimzadeh MH, Moradi A, Pour MK, Moghadam
MH, Kachooei AR. Clinical outcomes after arthroscopic
release for recalcitrant frozen shoulder. Arch Bone Jt
Surg. 2014; 2(3):220-4.
2. Kachooei AR, Moradi A, Janssen SJ, Ring D. The
influence of dominant limb involvement on DASH and
QuickDASH. Hand (N Y). 2015; 10(3):512-5.
3. Ebrahimzadeh MH, Birjandinejad A, Golhasani F,
Moradi A, Vahedi E, Kachooei AR. Cross-cultural
adaptation, validation, and reliability testing of the
Shoulder Pain and Disability Index in the Persian
population with shoulder problems. Int J Rehabil Res.
2015; 38(1):84-7.
4. Lehtinen JT, Tetreault P, Warner JJ. Arthroscopic
management of painful and stiff scapulothoracic
articulation. Arthroscopy. 2003; 19(4):E28.
5. Boneti C, Arentz C, Klimberg VS. Scapulothoracic
bursitis as a significant cause of breast and chest wall
pain: underrecognized and undertreated. Ann Surg
Oncol. 2010; 17(Suppl 3):321-4.
6. Warth RJ, Spiegl UJ, Millett PJ. Scapulothoracic
bursitis and snapping scapula syndrome: a critical
review of current evidence. Am J Sports Med. 2014;
43(1):236-45.
7. Chang WH, Im SH, Ryu JA, Lee SC, Kim JS. The effects
of scapulothoracic bursa injections in patients with
scapular pain: a pilot study. Arch Phys Med Rehabil.
2009; 90(2):279-84.
8. Conduah AH, Baker CL 3rd, Baker CL Jr. Clinical
management of scapulothoracic bursitis and the
snapping scapula. Sports Health. 2010; 2(2):147-55.
9. Son SA, Lee DH, Lee YO, Lee SC, Kim KJ, Cho JY. Operative
management in a patient with scapulothoracic
bursitis. Korean J Thorac Cardiovasc Surg. 2013;
46(6):486-9.
10. Noguchi M, Chopp JN, Borgs SP, Dickerson CR.
Scapular orientation following repetitive prone
rowing: implications for potential subacromial
impingement mechanisms. J Electromyogr Kinesiol.
2013; 23(6):1356-61.
11. Celik D. Comparison of the outcomes of two different
exercise programs on frozen shoulder. Acta Orthop
Traumatol Turc. 2010; 44(4):285-92.