Impingement徴候陽性患者におけるX線学的因子の検討

抄録

The purpose of this study was to identify radiographical characteristics of patients with the positive impingement signs. One hundred thirty-four patients (average age; 59.3 years old) positive for Neer's and Hawkins' impingement tests were the subjects of this study. Based on radiographic images of the shoulder A-P and scapular Y, the acromion shape, the acromion slope, subacromial spur, glenoid spur and changes in the greater tuberosity were investigated. One hundred nine patients (average age; 50.8 years old) without the signs and who had radiographies due to injury were enrolled as the control group. There was no difference in the acromion shape and slope between the two groups. The appearance of the subacromial spur showed no correlation between the two groups, but the spur size of the impingement group was statistically larger than that of the control group. The appearance of a glenoid spur and sclerosis of the greater tuberosity in the impingement group was also statistically higher than that in the control group. This study suggests that the acromion shape and slope may not be factors that induce the impingement signs, and the subacromial spur may be a secondary change induced by impingement. We considered that a minor instability of the glenohumeral joint due to an imbalance or motor weakness of the rotator cuff may exist in patients positive with the signs because of the significant appearance of inferior glenoid spur that is called traction spurs. Therefore, we concluded that the major causes in the development of the subacromial impingement are intrinsic factors such as an imbalance or weakness of the rotator cuff due to trauma or degeneration.