Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders

Abstract Objectives: The acromiohumeral distance (AHD) is widely used to evaluate subacromial pathology, particularly rotator cuff–related disorders. However, substantial heterogene- ity exists across studies in imaging protocols, measurement definitions, and diagnostic thresholds. This systematic r...

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Autores: Luis Palomeque-Del-Cerro, Arráez Aybar, Luis Alfonso, García De Pereda Notario, Carlos Miguel, Montoya Miñano, Juan José
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/130232
Acceso en línea:https://hdl.handle.net/20.500.14352/130232
Access Level:acceso abierto
Palabra clave:611
Acromiohumeral distance
Shoulder pain
Rotator cuff tear
Ultrasound
Imaging
diagnostic accuracy
Subacromial space
Ciencias Biomédicas
32 Ciencias Médicas
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spelling Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder DisordersLuis Palomeque-Del-CerroArráez Aybar, Luis AlfonsoGarcía De Pereda Notario, Carlos MiguelMontoya Miñano, Juan José611Acromiohumeral distanceShoulder painRotator cuff tearUltrasoundImagingdiagnostic accuracySubacromial spaceCiencias Biomédicas32 Ciencias MédicasAbstract Objectives: The acromiohumeral distance (AHD) is widely used to evaluate subacromial pathology, particularly rotator cuff–related disorders. However, substantial heterogene- ity exists across studies in imaging protocols, measurement definitions, and diagnostic thresholds. This systematic review aimed to synthesize current evidence on AHD measure- ment methods, assess reliability and diagnostic performance across imaging modalities, and examine the clinical relevance of AHD as both a structural and functional biomarker. Methods: A systematic search of PubMed, Web of Science, and SciELO (January 2006– May 2025) was conducted following PRISMA 2020. Eligible studies reported quantitative AHD measurements using ultrasound, MRI, or radiography in adults. Two reviewers independently conducted screening, extraction, and QUADAS-2 assessments. Due to heterogeneity, results were narratively synthesized. Results: Twenty-nine studies met the inclusion criteria. Definitions of AHD and imaging procedures varied substantially. Ultrasound showed the most consistent intra- and inter-observer reliability, whereas MRI and radiography demonstrated greater protocol-dependent variability. Reduced AHD values were frequently associated with full-thickness rotator cuff tears, while larger values typically characterized asymptomatic individuals. Several studies also reported reductions in AHD during arm elevation, supporting its interpretation as a functional parameter influenced by scapular motion and neuromuscular control. Conclusions: AHD is a reliable and clinically informative measure when acquired using standardized protocols, with Ultrasound demonstrating the highest reproducibility. Its sensitivity to positional and dynamic factors supports its role as both a structural and functional biomarker. Further research should prioritize standardized imaging procedures, dynamic assessment methods, and evaluation of emerging technologies to improve the diagnostic and prognostic value of AHD.MDPIUniversidad Complutense de Madrid20252025-12-1520252025-12-15journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/130232reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1302322026-06-02T12:44:21Z
dc.title.none.fl_str_mv Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
title Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
spellingShingle Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
Luis Palomeque-Del-Cerro
611
Acromiohumeral distance
Shoulder pain
Rotator cuff tear
Ultrasound
Imaging
diagnostic accuracy
Subacromial space
Ciencias Biomédicas
32 Ciencias Médicas
title_short Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
title_full Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
title_fullStr Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
title_full_unstemmed Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
title_sort Acromiohumeral Distance as a Diagnostic and Prognostic Biomarker for Shoulder Disorders: A Systematic Review—Acromiohumeral Distance and Shoulder Disorders
dc.creator.none.fl_str_mv Luis Palomeque-Del-Cerro
Arráez Aybar, Luis Alfonso
García De Pereda Notario, Carlos Miguel
Montoya Miñano, Juan José
author Luis Palomeque-Del-Cerro
author_facet Luis Palomeque-Del-Cerro
Arráez Aybar, Luis Alfonso
García De Pereda Notario, Carlos Miguel
Montoya Miñano, Juan José
author_role author
author2 Arráez Aybar, Luis Alfonso
García De Pereda Notario, Carlos Miguel
Montoya Miñano, Juan José
author2_role author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 611
Acromiohumeral distance
Shoulder pain
Rotator cuff tear
Ultrasound
Imaging
diagnostic accuracy
Subacromial space
Ciencias Biomédicas
32 Ciencias Médicas
topic 611
Acromiohumeral distance
Shoulder pain
Rotator cuff tear
Ultrasound
Imaging
diagnostic accuracy
Subacromial space
Ciencias Biomédicas
32 Ciencias Médicas
description Abstract Objectives: The acromiohumeral distance (AHD) is widely used to evaluate subacromial pathology, particularly rotator cuff–related disorders. However, substantial heterogene- ity exists across studies in imaging protocols, measurement definitions, and diagnostic thresholds. This systematic review aimed to synthesize current evidence on AHD measure- ment methods, assess reliability and diagnostic performance across imaging modalities, and examine the clinical relevance of AHD as both a structural and functional biomarker. Methods: A systematic search of PubMed, Web of Science, and SciELO (January 2006– May 2025) was conducted following PRISMA 2020. Eligible studies reported quantitative AHD measurements using ultrasound, MRI, or radiography in adults. Two reviewers independently conducted screening, extraction, and QUADAS-2 assessments. Due to heterogeneity, results were narratively synthesized. Results: Twenty-nine studies met the inclusion criteria. Definitions of AHD and imaging procedures varied substantially. Ultrasound showed the most consistent intra- and inter-observer reliability, whereas MRI and radiography demonstrated greater protocol-dependent variability. Reduced AHD values were frequently associated with full-thickness rotator cuff tears, while larger values typically characterized asymptomatic individuals. Several studies also reported reductions in AHD during arm elevation, supporting its interpretation as a functional parameter influenced by scapular motion and neuromuscular control. Conclusions: AHD is a reliable and clinically informative measure when acquired using standardized protocols, with Ultrasound demonstrating the highest reproducibility. Its sensitivity to positional and dynamic factors supports its role as both a structural and functional biomarker. Further research should prioritize standardized imaging procedures, dynamic assessment methods, and evaluation of emerging technologies to improve the diagnostic and prognostic value of AHD.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-12-15
2025
2025-12-15
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/130232
url https://hdl.handle.net/20.500.14352/130232
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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