MyPACS.net: Radiology Teaching Files > Case 4217107

previously visited OS ACROMIALE OF THE SHOULDER
Contributed by: Fritsch & Thompson, Radiologist, Diagnostic Radiology of Houston, Texas, USA.
Patient: 32 year old male
History:
Shoulder pain and limited range of motion; rule out rotator cuff tear.
Images:[small]larger

Fig. 1: Internal Rotation

Fig. 2: External Rotation

Fig. 3: Axillary View - limited (Patient could not abduct arm)

Fig. 4: GRE Axial

Fig. 5: PD Fatsat Axial

Fig. 6: PD Fatsat Coronal

Fig. 7: PD Fatsat Coronal

Fig. 8: T1 Sagittal

Fig. 9: T1 Sagittal
Findings:

  • Negative x-ray.
  • MRI of the shoulder reveals os acromiale.
  • Tendonosis of rotator cuff; no tears.

Diagnosis:
OS ACROMIALE WITH TYPE I ACROMIAL CONFIGURATION.
Discussion:

Os acromiale is failure of fusion of one of the outer ossification centers of the acromion to its more medial part.á Atáthe age of approximately 15 years, 3 separate ossifying centers are present in the acromion, the pre-acromion, meso-acromion, and meta-acromion.á Typically by the age of 25 years, these centers have fused.á The most common sight of fusion failure is at the meso-acromion.á This condition occurs in 1% to 15%of patients.á Bilaterality is seen in 62% of patients.á Osacromiale has been associated with rotator cuff disease, primarily rotator cuff tears.á Impingement syndrome without rotator cuff tearing has been less commonly described, and the treatment of this impingement has been controversial.


http://www.sportsandortho.com/past_research_decompression_for_impingement_syndrome.htm


http://www.ptcentral.com/radiology/Shoulder/Shoulder.html

http://www.shoulderdoc.bluenewmedia.co.uk/news/archive.asp?region=shoulderžion=101

http://www.chiroweb.com/archives/21/18/04.html

http://www.aafp.org/afp/980215ap/fongemie.html

http://www.gvle.de/kompendium/schulter/14/03.html

References:

Patient referred by Billie Martin, DC

Constant Contact
Case of the Week:á 3/29/2006

MRI Case of the Weel: 11/29/06
Comments:
Too bad there is not an axial conventional X-ray of this shoulder--Dirk Schonfeld, 2007-03-01
Additional Details:

Case Number: 4217107Last Updated: 01-08-2008
Anatomy: Skeletal System   Pathology: Normal/Variants
Modality: Conventional Radiograph, MRExam Date: 03-10-2006Access Level: Readable by all users
Keywords: shoulder, os acromiale,normal variants

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