Skip to main content
SpringerLink
Log in

How does computed tomography inform our understanding of shoulder kinematics? A structured review

  • Review Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

The objective of this structured review was to review how computed tomography (CT) scanning has been used to measure the kinematics of the shoulder. A literature search was conducted using Evidence-based Medicine Reviews (Embase) and PubMed. In total, 29 articles were included in the data extraction process. Forty percent of the studies evaluated healthy participants’ shoulder kinematics. The glenohumeral joint was the most studied, followed by the scapulothoracic, acromioclavicular, and sternoclavicular joints. Three-dimensional computed tomography (3DCT) and 3DCT with biplane fluoroscopy are the two primary imaging techniques that have been used to measure shoulder joints’ motion under different conditions. Finally, many discrepancies in the reporting of the examined motions were found. Different authors used different perspectives and planes to report similar motions, which results in confusion and misunderstanding of the actual examined motion. The use of 3DCT has been widely used in the examination of shoulder kinematics in a variety of populations with varying methods employed. Future work is needed to extend these methodologies to include more diverse populations, to examine the shoulder complex as a whole, and to standardize their reporting of motion examined to make study to study comparisons possible.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Not applicable.

Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

CT:

Computed tomography

3DCT:

Three-dimensional computed tomography

4DCT:

Four-dimensional computed tomography

ISB:

International Society of Biomechanics

6 DoF:

six degrees of freedom

References

  1. Lefèvre-Colau M-M, Nguyen C, Palazzo C, Srour F, Paris G, Vuillemin V et al (2018) Recent advances in kinematics of the shoulder complex in healthy people. Ann Phys Rehabil Med 61(1):56–59

    Article  PubMed  Google Scholar 

  2. Bakhsh W, Nicandri G (2018) Anatomy and Physical Examination of the Shoulder. Sports Med Arthrosc Rev 26(3):e10–e22. https://doi.org/10.1097/JSA.0000000000000202

  3. Veeger HEJ, van der Helm FCT (2007) Shoulder function: the perfect compromise between mobility and stability. J Biomech 40(10):2119–2129

    Article  CAS  PubMed  Google Scholar 

  4. Chang L-R, Anand P, Varacallo M (2020) Anatomy, shoulder and upper limb, glenohumeral joint [Internet]. StatPearls [Internet]. StatPearls Publishing; 2020 [cited 2020 Jul 1]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537018/

  5. Viceconti M. (2011) Multiscale modeling of the skeletal system [Internet]. Cambridge: Cambridge University Press; 2011 [cited 2020 Jun 7]. Available from: https://www.cambridge.org/core/books/multiscale-modeling-of-the-skeletal-system/95E1B6FDC874814AA924EF4574144175

  6. Gielen CCAM, van Bolhuis BM, Theeuwen M (1995) On the control of biologically and kinematically redundant manipulators. Hum Mov Sci 14(4):487–509

    Article  Google Scholar 

  7. Rau G, Disselhorst-Klug C, Schmidt R (2000) Movement biomechanics goes upwards: from the leg to the arm. J Biomech 33(10):1207–1216

    Article  CAS  PubMed  Google Scholar 

  8. Krishnan R, Björsell N, Gutierrez-Farewik EM, Smith C (2019) A survey of human shoulder functional kinematic representations. Med Biol Eng Comput 57(2):339–367

    Article  PubMed  Google Scholar 

  9. Högfors C, Sigholm G, Herberts P (1987) Biomechanical model of the human shoulder—I. Elements. J Biomech 20(2):157–166

    Article  PubMed  Google Scholar 

  10. Karlsson D, Peterson B (1992) Towards a model for force predictions in the human shoulder. J Biomech 25(2):189–199

    Article  CAS  PubMed  Google Scholar 

  11. Xu X, Lin J, McGorry RW (2014) A regression-based 3-D shoulder rhythm. J Biomech 47(5):1206–1210

    Article  PubMed  Google Scholar 

  12. Gopura RARC, Bandara DSV, Kiguchi K, Mann GKI (2016) Developments in hardware systems of active upper-limb exoskeleton robots: a review. Robot Auton Syst 1(75):203–220

    Article  Google Scholar 

  13. Lo HS, Xie SQ (2012) Exoskeleton robots for upper-limb rehabilitation: state of the art and future prospects. Med Eng Phys 34(3):261–268

    Article  PubMed  Google Scholar 

  14. Favre P, Snedeker JG, Gerber C (2009) Numerical modelling of the shoulder for clinical applications. Phil Trans R Soc A: Math, Phys Eng Sci 367(1895):2095–118

    Article  Google Scholar 

  15. Murphy MA, Häger CK (2015) Kinematic analysis of the upper extremity after stroke – how far have we reached and what have we grasped? Phys Ther Rev 20(3):137–155

    Article  Google Scholar 

  16. Seth A, Matias R, Veloso AP, Delp SL (2016) A biomechanical model of the scapulothoracic joint to accurately capture scapular kinematics during shoulder movements. PLoS ONE 11(1):e0141028

    Article  PubMed  PubMed Central  Google Scholar 

  17. Baumer TG, Giles JW, Drake A, Zauel R, Bey MJ (2016) Measuring three-dimensional thorax motion via biplane radiographic imaging: technique and preliminary results. J Biomech Eng. 138(1).

  18. Bey MJ, Kline SK, Zauel R, Lock TR, Kolowich PA (2008) Measuring dynamic in-vivo glenohumeral joint kinematics: technique and preliminary results. J Biomech 41(3):711–714

    Article  PubMed  Google Scholar 

  19. Dal Maso F, Blache Y, Raison M, Lundberg A, Begon M (2016) Glenohumeral joint kinematics measured by intracortical pins, reflective markers, and computed tomography: a novel technique to assess acromiohumeral distance. J Electromyogr Kinesiol 29:4–11

    Article  Google Scholar 

  20. Matsuki K, Kenmoku T, Ochiai N, Sugaya H, Banks SA (2016) Differences in glenohumeral translations calculated with three methods: comparison of relative positions and contact point. J Biomech 49(9):1944–7

    Article  PubMed  Google Scholar 

  21. Matsumura N, Oki S, Fukasawa N, Matsumoto M, Nakamura M, Nagura T et al (2019) Glenohumeral translation during active external rotation with the shoulder abducted in cases with glenohumeral instability: a 4-dimensional computed tomography analysis. J Shoulder Elbow Surg 28(10):1903–1910

    Article  PubMed  Google Scholar 

  22. Mozingo JD, Akbari-Shandiz M, Van Straaten MG, Murthy NS, Schueler BA, Holmes DR et al (2019) Comparison of glenohumeral joint kinematics between manual wheelchair tasks and implications on the subacromial space: a biplane fluoroscopy study. J Electromyogr Kinesiol 23:102350

    Google Scholar 

  23. Bell SN, Troupis JM, Miller D, Alta TD, Coghlan JA, Wijeratna MD (2015) Four-dimensional computed tomography scans facilitate preoperative planning in snapping scapula syndrome. J Shoulder Elbow Surg 24(4):e83-90

    Article  PubMed  Google Scholar 

  24. Alta TD, Bell SN, Troupis JM, Coghlan JA, Miller D (2012) The New 4-Dimensional computed tomographic scanner allows dynamic visualization and measurement of normal acromioclavicular joint motion in an unloaded and loaded condition. J Comput Assist Tomogr 36(6):749–754

    Article  PubMed  Google Scholar 

  25. Hislop-Jambrich J, Troupis J, Moaveni A (2016) The use of a dynamic 4-dimensional computed tomography scan in the diagnosis of atraumatic posterior sternoclavicular joint instability. J Comput Assist Tomogr 40(4):576–577

    Article  PubMed  Google Scholar 

  26. Fung M, Kato S, Barrance PJ, Elias JJ, McFarland EG, Nobuhara K et al (2001) Scapular and clavicular kinematics during humeral elevation: a study with cadavers. J Shoulder Elbow Surg 10(3):278–285

    Article  CAS  PubMed  Google Scholar 

  27. Kijima T, Matsuki K, Ochiai N, Yamaguchi T, Sasaki Y, Hashimoto E et al (2015) In vivo 3-dimensional analysis of scapular and glenohumeral kinematics: comparison of symptomatic or asymptomatic shoulders with rotator cuff tears and healthy shoulders. J Shoulder Elbow Surg 24(11):1817–1826

    Article  PubMed  Google Scholar 

  28. Kozono N, Okada T, Takeuchi N, Hamai S, Higaki H, Ikebe S et al (2017) In vivo kinematic analysis of the glenohumeral joint during dynamic full axial rotation and scapular plane full abduction in healthy shoulders. Knee Surg Sports Traumatol Arthrosc 25(7):2032–2040

    Article  PubMed  Google Scholar 

  29. Kozono N, Okada T, Takeuchi N, Hamai S, Higaki H, Shimoto T et al (2018) Dynamic kinematics of the glenohumeral joint in shoulders with rotator cuff tears. J Orthop Surg Res 13(1):9

    Article  PubMed  PubMed Central  Google Scholar 

  30. Kozono N, Okada T, Takeuchi N, Hamai S, Higaki H, Shimoto T et al (2018) In vivo dynamic acromiohumeral distance in shoulders with rotator cuff tears. Clin Biomech (Bristol, Avon) 60:95–99

    Article  PubMed  Google Scholar 

  31. Matsuki K, Matsuki KO, Mu S, Yamaguchi S, Ochiai N, Sasho T et al (2011) In vivo 3-dimensional analysis of scapular kinematics: comparison of dominant and nondominant shoulders. J Shoulder Elbow Surg 20(4):659–665

    Article  PubMed  Google Scholar 

  32. Matsuki K, Matsuki KO, Yamaguchi S, Ochiai N, Sasho T, Sugaya H et al (2012) Dynamic in vivo glenohumeral kinematics during scapular plane abduction in healthy shoulders. J Orthop Sports Phys Ther 42(2):96–104

    Article  PubMed  Google Scholar 

  33. Matsuki K, Matsuki KO, Mu S, Kenmoku T, Yamaguchi S, Ochiai N et al (2014) In vivo 3D analysis of clavicular kinematics during scapular plane abduction: comparison of dominant and non-dominant shoulders. Gait Posture 39(1):625–627

    Article  PubMed  Google Scholar 

  34. Nishinaka N, Tsutsui H, Mihara K, Suzuki K, Makiuchi D, Kon Y et al (2008) Determination of in vivo glenohumeral translation using fluoroscopy and shape-matching techniques. J Shoulder Elbow Surg 17(2):319–322

    Article  PubMed  Google Scholar 

  35. Bakshi NK, Jameel OF, Merrill ZF, Debski RE, Sekiya JK (2016) The influence of surgical stabilization on glenohumeral abduction using 3-dimensional computed tomography in patients with shoulder instability. Arthrosc 32(8):1495–1501

    Article  Google Scholar 

  36. Elwell J, Choi J, Willing R (2017) Quantifying the competing relationship between adduction range of motion and baseplate micromotion with lateralization of reverse total shoulder arthroplasty. J Biomech 08(52):24–30

    Article  Google Scholar 

  37. Giphart JE, Brunkhorst JP, Horn NH, Shelburne KB, Torry MR, Millett PJ (2013) Effect of plane of arm elevation on glenohumeral kinematics: a normative biplane fluoroscopy study. J Bone Joint Surg Am 95(3):238–245

    Article  PubMed  Google Scholar 

  38. Jeon B-K, Panchal KA, Ji J-H, Xin Y-Z, Park S-R, Kim J-H et al (2016) Combined effect of change in humeral neck-shaft angle and retroversion on shoulder range of motion in reverse total shoulder arthroplasty - a simulation study. Clin Biomech (Bristol, Avon) 31:12–19

    Article  PubMed  Google Scholar 

  39. Kim DS, Lee B, Banks SA, Hong K, Jang YH (2017) Comparison of dynamics in 3D glenohumeral position between primary dislocated shoulders and contralateral healthy shoulders. J Orthop 14(1):195–200

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Kim E, Park JH, Han B-R, Park HJ, Lee SY, Murase T et al (2017) In vivo analysis of three-dimensional dynamic scapular dyskinesis in scapular or clavicular fractures. Acta Med Okayama 71(2):151–159

    PubMed  Google Scholar 

  41. Kim YS, Yoo Y-S, Jang SW, Nair AV, Jin H, Song H-S (2015) In vivo analysis of acromioclavicular joint motion after hook plate fixation using three-dimensional computed tomography. J Shoulder Elbow Surg 24(7):1106–1111

    Article  PubMed  Google Scholar 

  42. Clément J, Ménard J, Raison M, Dumais J, Dubois L, Rouleau DM (2017) Three-dimensional analysis of the locked position in patients with recurrent shoulder instability. J Shoulder Elbow Surg 26(3):536–543

    Article  PubMed  Google Scholar 

  43. Werner BS, Chaoui J, Walch G (2017) The influence of humeral neck shaft angle and glenoid lateralization on range of motion in reverse shoulder arthroplasty. J Shoulder Elbow Surg 26(10):1726–1731

    Article  PubMed  Google Scholar 

  44. Werner BS, Chaoui J, Walch G (2018) Glenosphere design affects range of movement and risk of friction-type scapular impingement in reverse shoulder arthroplasty. Bone Joint J 100–B(9):1182–6

    Article  PubMed  Google Scholar 

  45. Lädermann A, Tay E, Collin P, Piotton S, Chiu C-H, Michelet A et al (2019) Effect of critical shoulder angle, glenoid lateralization, and humeral inclination on range of movement in reverse shoulder arthroplasty. Bone Joint Res 8(8):378–386

    Article  PubMed  PubMed Central  Google Scholar 

  46. Baeyens JP, Van Roy P, De Schepper A, Declercq G, Clarijs JP (2001) Glenohumeral joint kinematics related to minor anterior instability of the shoulder at the end of the late preparatory phase of throwing. Clin Biomech (Bristol, Avon) 16(9):752–757

    Article  CAS  PubMed  Google Scholar 

  47. Kim E, Lee S, Jeong H-J, Park JH, Park S-J, Lee J et al (2018) Three-dimensional scapular dyskinesis in hook-plated acromioclavicular dislocation including hook motion. J Shoulder Elbow Surg 27(6):1117–1124

    Article  PubMed  Google Scholar 

  48. Wu G, van der Helm FCT, DirkJan Veeger HEJ, Makhsous M, Van Roy P, Anglin C et al (2005) ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion—Part II: shoulder, elbow, wrist and hand. J Biomech 38(5):981–92

    Article  CAS  PubMed  Google Scholar 

  49. Barnes CJ, Van Steyn SJ, Fischer RA (2001) The effects of age, sex, and shoulder dominance on range of motion of the shoulder. J Shoulder Elbow Surg 10(3):242–246

    Article  CAS  PubMed  Google Scholar 

  50. Williams S, Schmidt R, Disselhorst-Klug C, Rau G (2006) An upper body model for the kinematical analysis of the joint chain of the human arm. J Biomech 39(13):2419–2429

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada

    Baraa Daher, James Hunter & Emily A. Lalone

  2. Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada

    Baraa Daher, James Hunter & Emily A. Lalone

  3. Bone and Joint Institute, Western University, London, Canada

    Baraa Daher, George S. Athwal & Emily A. Lalone

  4. Department of Surgery, Western University, London, Canada

    George S. Athwal & Emily A. Lalone

  5. Roth|McFarlane Hand and Upper Limb Centre, St. Joseph’s Health Care, London, ON, Canada

    George S. Athwal & Emily A. Lalone

  6. Lawson Health Research Institute, London, ON, Canada

    George S. Athwal & Emily A. Lalone

Authors
  1. Baraa Daher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James Hunter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George S. Athwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emily A. Lalone
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BD: literature review, data extraction, data analysis, and manuscript writing; JH: data revision and data organization; GA: project supervision, manuscript reviewing and revising, and resource to clinical gaps and knowledge; EL: project supervision, literature review, concept and design, manuscript reviewing and revising, and approving the final manuscript.

Corresponding author

Correspondence to Emily A. Lalone.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Daher, B., Hunter, J., Athwal, G.S. et al. How does computed tomography inform our understanding of shoulder kinematics? A structured review. Med Biol Eng Comput 61, 967–989 (2023). https://doi.org/10.1007/s11517-022-02755-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-022-02755-1

Keywords

Search

Navigation