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- Title
Differentiating os acromiale from normally developing acromial ossification centers using magnetic resonance imaging.
- Authors
Winfeld, Matthew; Rosenberg, Zehava; Wang, Annie; Bencardino, Jenny
- Abstract
Objective: Acromial fusion may not be complete until age 18-25, making it questionable to diagnose os acromiale in adolescents. Os acromiale may exist in adolescents and can be differentiated from a developing acromial ossification center based on MRI findings. Materials and methods: A total of 128 MRIs of the shoulder were randomly and blindly reviewed retrospectively by two musculoskeletal radiologists. The MRIs consisted of two groups: (1) 56 of os acromiale in adults (25-74 years old, mean, 50) and (2) 72 consecutive of adolescents (12-17 years old, mean, 14.5). The following were assessed at the interface between the distal acromion and os acromiale/developing ossification center(s): presence of os acromiale vs. developing acromion, orientation, margins, and edema within and adjacent to it. Results: Fifty-one adults and 49 adolescents were included. Exclusions were due to poor image quality or confounding findings ( n = 7) or complete acromial fusion ( n = 21 adolescents). Utilizing accepted definitions of os acromiale, all adult cases (100 %) were accurately diagnosed as os acromiale, with transverse interface orientation and irregular margins (94 %, R = 0.86, p < 0.00001). Forty-five (92 %) adolescent cases were accurately diagnosed as normally developing acromion with arched interface and lobulated margins (92 %, R = 0.92, p < 0.000001). Four (8 %) adolescent cases were diagnosed as having os acromiale, with transverse orientation and irregular margins. Thirty-five (69 %) and 46 (90 %) adults had marrow and interface edema, respectively. Six (12 %) and eight (16 %) adolescents had marrow and interface edema, respectively, including the four concluded to be os acromiale. Conclusions: Adolescents may have imaging findings consistent with os acromiale. The diagnosis of os acromiale should be based on imaging features and not limited by age.
- Subjects
SHOULDER pain; ACROMION; OSSIFICATION; SHOULDER disorders; MAGNETIC resonance imaging
- Publication
Skeletal Radiology, 2015, Vol 44, Issue 5, p667
- ISSN
0364-2348
- Publication type
Article
- DOI
10.1007/s00256-015-2098-4