The use of computerized tomography in the measurement of glenoid version.

TLDR

The study examined 20 shoulders, of which 10 had osteoarthrosis, 8 had rheumatoid arthritis, and 2 had gouty arthritis. The authors aimed to establish normal glenoid version values by retrospectively analyzing CT scans of 63 asymptomatic patients as a control group. CT scans were performed preoperatively on 20 arthritic shoulders to measure glenoid version, and chest CTs of 63 asymptomatic patients were retrospectively reviewed for comparison. Severe arthritis patients exhibited a mean glenoid retroversion of 11° (range 2° anteversion to 32° retroversion) versus 2° anteversion (range 14° anteversion to 12° retroversion) in controls, with the difference highly significant (p < 0.0001), and CT accurately depicted erosive changes and posterior humeral head displacement.

Abstract

Computerized tomography was done preoperatively on twenty shoulders (thirteen patients) in which there were severe arthritic changes, to measure glenoid version. Ten of the twenty shoulders had osteoarthrosis; eight, rheumatoid arthritis; and two, gouty arthritis. To help determine normal values, computerized tomographic scans of the chest of sixty-three patients who did not have roentgenographic evidence of disease of the shoulder were studied retrospectively for comparison as a control group. In the group of patients who had severe arthritis, the mean glenoid orientation was 11 degrees of retroversion (range, 2 degrees of anteversion to 32 degrees of retroversion). The computerized tomographic scans showed uneven wear of the glenoid surface, osteophytes, large cysts, and posterior displacement of the humeral head. In the control group, the mean orientation of the glenoid was 2 degrees of anteversion (range, 14 degrees of anteversion to 12 degrees of retroversion). The difference between the groups was significant (p less than 0.0001). Glenoid retroversion was increased in the patients who had severe arthritis, and the computerized tomographic scans accurately revealed the extent and pattern of erosion of the bone.