MOJ Header

Current Issue - November 2022, Volume 16, Issue No. 3

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Reliability of Bigliani’s Classification using Magnetic Resonance Imaging for Determination of Acromial Morphology


  1. Balke M, Liem D, Greshake O, Hoeher J, Bouillon B, Banerjee M. Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears. Knee Surg Sports Traumatol Arthrosc. 2016; 24(7): 2200-5. doi: 10.1007/s00167-014-3499-y
  2. Bigliani LU, Ticker JB, Flatow EL, Soslowsky LJ, Mow VC. The relationship of acromial architecture to rotator cuff disease. Clin Sports Med. 1991; 10(4): 823-38.
  3. Fukuda H, Hamada K, Yamanaka K. Pathology and pathogenesis of bursal-side rotator cuff tears viewed from en bloc histologic sections. Clin Orthop Relat Res. 1990; (254): 75-80.
  4. Gill TJ, McIrvin E, Kocher MS, Homa K, Mair SD, Hawkins RJ. The relative importance of acromial morphology and age with respect to rotator cuff pathology. J Shoulder Elbow Surg. 2002; 11(4): 327-30. doi: 10.1067/mse.2002.124425
  5. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972; 54(1): 41-50.
  6. Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986; 10: 228.
  7. Vanarthos WJ, Monu JU. Type 4 acromion: a new classification. Contemp Orthop. 1995; 30(3): 227-9.
  8. Mallon WJ, Brown HR, Vogler JB 3rd, Martinez S. Radiographic and geometric anatomy of the scapula. Clin Orthop Relat Res. 1992; (277): 142-54.
  9. Jacobson SR, Speer KP, Moor JT, Janda DH, Saddemi SR, MacDonald PB, et al. Reliability of radiographic assessment of acromial morphology. J Shoulder Elbow Surg. 1995; 4(6): 449-53. doi: 10.1016/s1058-2746(05)80037-0
  10. Park TS, Park DW, Kim SI, Kweon TH. Roentgenographic assessment of acromial morphology using supraspinatus outlet radiographs. Arthroscopy. 2001; 17(5): 496-501. doi: 10.1053/jars.2001.23579
  11. Bright AS, Torpey B, Magid D, Codd T, McFarland EG. Reliability of radiographic evaluation for acromial morphology. Skeletal Radiol. 1997; 26(12): 718-21. doi: 10.1007/s002560050317
  12. Mayerhoefer ME, Breitenseher MJ, Roposch A, Treitl C, Wurnig C. Comparison of MRI and conventional radiography for assessment of acromial shape. AJR Am J Roentgenol. 2005; 184(2): 671-5. doi: 10.2214/ajr.184.2.01840671
  13. Peh WC, Farmer TH, Totty WG. Acromial arch shape: assessment with MR imaging. Radiology. 1995; 195(2): 501-5. doi: 10.1148/radiology.195.2.7724774
  14. Epstein RE, Schweitzer ME, Frieman BG, Fenlin JM Jr, Mitchell DG. Hooked acromion: prevalence on MR images of painful shoulders. Radiology. 1993; 187(2): 479-81. doi: 10.1148/radiology.187.2.8475294
  15. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1): 159-74.
  16. Balke M, Schmidt C, Dedy N, Banerjee M, Bouillon B, Liem D. Correlation of acromial morphology with impingement syndrome and rotator cuff tears. Acta Orthop. 2013; 84(2): 178-83. doi: 10.3109/17453674.2013.773413
  17. Banas MP, Miller RJ, Totterman S. Relationship between the lateral acromion angle and rotator cuff disease. J Shoulder Elbow Surg. 1995; 4(6): 454-61.
  18. Chambler AF, Pitsillides AA, Emery RJ. Acromial spur formation in patients with rotator cuff tears. J Shoulder Elbow Surg. 2003; 12(4): 314-21. doi: 10.1016/s1058-2746(03)00030-2
  19. Worland RL, Lee D, Orozco CG, SozaRex F, Keenan J. Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. J South Orthop Assoc. 2003; 12(1): 23-6
  20. Yazici M, Kopuz C, Gulman B. Morphologic variants of acromion in neonatal cadavers. J Pediatr Orthop. 1995; 15(5): 644-7. doi: 10.1097/01241398-199509000-00019
  21. Wang JC, Shapiro MS. Changes in acromial morphology with age. J Shoulder Elbow Surg. 1997; 6(1): 55-9. doi: 10.1016/S1058-2746(97)90071-9
  22. Ozaki J, Fujimoto S, Nakagawa Y, Masuhara K, Tamai S. Tears of the rotator cuff of the shoulder associated with pathological changes in the acromion. A study in cadavera. J Bone Joint Surg Am. 1988; 70(8): 1224-30.
  23. Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg. 1996; 5(1): 1-11. doi: 10.1016/s1058-2746(96)80024-3
  24. Ogata S, Uhthoff HK. Acromial enthesopathy and rotator cuff tear. A radiologic and histologic postmortem investigation of the coracoacromial arch. Clin Orthop Relat Res. 1990; (254): 39-48.
  25. Harris JE, Blackney MC. The anatomy and function of the coracoacromial ligament. J Shoulder Elbow Surg. 1993; 2(Suppl): 6-9.
  26. Morrison DS, Bigliani LU. Roentgenographic analysis of acromial morphology and its relationship to rotator cuff tears. Orthop Trans. 1987; 11(439): 41-50.
  27. Morrison DS. The clinical significance of variations in acromial morphology. Orthop Trans. 1987; 11: 234.
  28. Aoki M, Ishii S, Usui M. Clinical application for measuring the slope of the acromion. In: Post M, Morrey B, Hawkins R, editors. Surgery of the shoulder. St. Louis: Mosby; 1990. p 200-3.
  29. Incesoy MA, Yildiz KI, Turk OI, Akinci S, Turgut E, Aycan OE, et al. The critical shoulder angle, the acromial index, the glenoid version angle and the acromial angulation are associated with rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2021; 29: 2257-63. doi: 10.1007/s00167-020-06145-8
  30. Beeler S, Hasler A, Gotschi T, Meyer DC, Gerber C. Critical shoulder angle: Acromial coverage is more relevant than glenoid inclination. J Orthop Res. 2019; 37(1): 205-10. doi: 10.1002/jor.24053

Abstract   |   Reference

MOJ footer

About Us

The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

Keep in Touch

creative-commons License