Without x-rays, is there a way to know a patient has a problem with Os Acromiale?
Answer
Not really. I think that the best bet is to get film, and Os Acromiale will show on an axillary view. It will also typically show on the AP if you get enough penetration distally. If you keep getting impingement signs; they have good, strong muscles; their scapulohumeral rhythm is normal; they have good manual muscle test for their external rotators and internal rotators; and you test that supraspinatus prone at 100 degrees of abduction, and they are just as strong but they continue to have these “impingement” signs, then I would look a little bit closer that maybe something might be lurking underneath like a bony abnormality. With just a quick look with an x-ray, you will get a good picture of that.
Steven Tippett, PT, PhD, SCS
Steve Tippett is presently the Chair of the Department of Physical Therapy and Health Science at Bradley University. His primary teaching responsibilities include undergraduate courses in kinesiology and in sport applications in the health sciences, as well as graduate instruction in extremity orthopedics. Steve treats Bradley students in conjunction with Bradley Health Services, is the physical therapist consultant to Bradley’s athletic department, and also sees out patients one-half day per week at OSF Saint Francis Medical Center.
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Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for .5 hour of general and 1.5 hour of Direct Access CE credit.
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