Measurement of the Coracohumeral Distance on MRI in a Large Patient Cohort.

2020 
Abstract Background Coracoid impingement syndrome is an increasingly recognized etiology of anterior shoulder pain. Numerus studies have documented the coracohumeral distance (CHD) as a primary or secondary measurement in symptomatic individuals, but there lacks an evaluation of CHD in a large cohort of asymptomatic individuals. The purpose of this study is to quantify a normative distribution of the coracohumeral distance in a large cohort of healthy, asymptomatic subjects with no history of impingement or shoulder instability. Methods Incoming first-year students in the United States Military Academy were offered enrollment in this study as part of a prospective cohort to assess the normal anatomic relationships of the shoulder girdle. Magnetic resonance images were obtained, and a board-certified, fellowship trained musculoskeletal radiologist performed measurements of the smallest distance from the coracoid to the humeral head on axial images. Results MR images of 714 subjects were available for analysis, including 630 males and 84 females, with a total of 1,120 individual shoulders with images of adequate quality. The mean CHD for all shoulders imaged was 13.7mm. The mean CHD in male shoulders was 13.8mm, and in female subject shoulders the average was 12.4mm. Conclusions This study is the largest of its kind to evaluate the CHD in asymptomatic, healthy shoulders to date, and demonstrates a mean CHD of 13.7mm for all subjects. This information can help to standardize “normal” ranges and act as a comparison for future work, when taken in the context of age and imaging in neutral rotation. Level of Evidence Anatomy Study; Imaging
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