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See 1 citation in J Shoulder Elbow Surg 2014:

J Shoulder Elbow Surg. 2014 Jun;23(6):821-8. doi: 10.1016/j.jse.2013.08.016. Epub 2013 Nov 23.

Revisit to scapular dyskinesis: three-dimensional wing computed tomography in prone position.

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Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, South Korea; Global Center for Shoulder & Elbow, Department of Orthopedic Surgery, Konkuk University Hospital, Seoul, South Korea.
Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University Medical College, Chuncheon-si, Gangwon-do, South Korea. Electronic address:
Department of Radiology, Konkuk University Hospital, Seoul, South Korea.
Gem Fitness, Seoul, South Korea.



Three-dimensional (3D) wing computed tomography (CT) showed a high inter-rater reliability in assessing scapular dyskinesis.


The 330 scapular movements of 165 patients were classified into 4 types by 7 blinded observers. Then, 3D wing CT was performed with patients prone, and 4 blinded observers measured 5 angles, consisting of upward rotation (UR) superior translation (ST), anterior tilting (AT), protraction (PRO), and internal rotation (IR). The inter-rater reliability (IRR) of 2 methods was calculated, and cutoff values were determined for the 5 angles on the 3D wing CT images.


The IRR was 0.783 for the observational method of scapular dyskinesis and 0.981 for 3D wing CT in the prone position. UR and ST angles were significantly larger in type 3 more than in the other types (P < .001, P < .001), and the AT angle showed a similar pattern in type 1 (P < .001). The PRO angle was significantly larger in types 1, 2, and 3 more than in type 4 (P < .001, P < .001, P = .013), and the IR angle was significantly larger in type 2 more than in the other types (P < .001). The cutoff values of the 5 angles were UR, 117°; ST, 90°; AT, 8°; PRO, 99°; and IR, 51°. The UR angle showed a significant correlation with glenohumeral internal rotation deficit (odds ratio, 0.436; P = .029) and the IR angle with MDI (odds ratio, 8.947; P = .048).


The patients with a high UR angle showed a low rate of glenohumeral internal rotation deficit and those with a high IR angle had a high rate of the MDI in affected shoulder by the determinant of the cutoff value of the 5 angles.


Level III, development of diagnostic criteria with nonconsecutive patients, diagnostic study.


3D wing CT; Scapular dyskinesis; concomitant disease; cutoff value; inter-rater reliability; observational method; prone position

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