Os Acromiale-unusual Manifestation as Superior Spur and Bursitis-A Case Report

Main Article Content

A. Raviraj
Vidyasagar Maalepati
K. Abhishek Sugumar
Vivek Kumar N. Savsani
Ajith K. Prabhu
Ashish Anand

Abstract

An Os acromiale is a condition that results from the failure of fusion of the anterior acromial apophysis. It can be asymptomatic. It can also result in subacromial impingement and rotator cuff tear. In this case report of a 39 year-old lady we would like to present the management of the painful bursitis and spur formation on the superior surface of a meso-type of os acromiale. Conservative management in the form of rest, anti-inflammatory drugs and physiotherapy did not provide symptomatic relief. Patient then underwent surgical excision of the superior spur. Open reduction and internal fixation was not carried out. Patient had resolution of pain and no recurrence of symptoms or features of impingement at 6 months follow up. To the best of our knowledge there are limited reports in English literature about this rare subset of patients with symptomatic os acromiale with superior spur formation and with no features of impingement or cuff pathology.

Keywords:
Superior spur, bursitis, acromial apophysis, anti-inflammatory drugs.

Article Details

How to Cite
Raviraj, A., Maalepati, V., Sugumar, K. A., Savsani, V. K. N., Prabhu, A. K., & Anand, A. (2019). Os Acromiale-unusual Manifestation as Superior Spur and Bursitis-A Case Report. Journal of Advances in Medicine and Medical Research, 31(2), 1-6. https://doi.org/10.9734/jammr/2019/v31i230284
Section
Case Report

References

McClure JG, Raney RB. Anomalies of the scapula. Clin Orthop Relat Res 1975;110: 22-31.

Sammarco VJ. Os acromiale: Frequency, anatomy, and clinical implications. J Bone Joint Surg Am. 2000;82:394-400.

Burkhart SS. Os acromiale in a professional tennis player. Am J Sports Med. 1992;20:483-484.

Peckett WR, Gunther SB, Harper GD, et al. Internal fixation of symptomatic os acromiale: a series of twenty-six cases. J Shoulder Elbow Surg. 2004;13:381-385.

Swain RA, Wilson FD, Harsha DM. The os acromiale: Another cause of impingement. Med Sci Sports Exerc. 1996;28:1459-1462.

Edelson JG, Zuckerman J, Hershkovitz I. Os acromiale: anatomy and surgical implications. J Bone Joint Surg Br. 1993; 75:551-555.

Mudge MK, Wod VE, Frykman GK. Rotator cuff tears associated with os acromiale. J Bone Joint Surg Am. 1984;66:427-429.

Demetracopoulos CA, Kapadia NS, Herickhoff PK, et al. Surgical stabilization of os acromiale in a fast-pitch softball pitcher. Am J Sports Med. 2006;34:1855-1859.

Hertel R, Windisch W, Schuster A, et al. Transacromial approach to obtain fusion of unstable os acromiale. J Shoulder Elbow Surg. 1998;7:606-609.

Sahajpal D, Strauss EJ, Ishak C, et al. Surgical management of os acromiale: a case report and review of the literature. Bull NYU Hosp Jt Dis. 2007;65:312-316.

Kurtz CA, Humble BJ, Rodosky MW, et al. Symptomatic os acromiale. J Am Acad Orthop Surg. 2006;14:12-19.

Ryu RK, Fan RS, Dunbar WH. The treatment of symptomatic os acromiale. Orthopedics. 1999;22:325-328.

Warner JJ, Beim GM, Higgins L. The treatment of symptomatic os acromiale. J Bone Joint Surg Am. 1998;80:1320-1326.

Jerosch J, Hepp R, Castro WH. An unfused acromial epiphysis. A reason for chronic shoulder pain. Acta Orthop Belg. 1991;57:309-312.

Hutchinson MR, Veenstra MA. Arthroscopic decompression of shoulder impingement secondary to os acromiale. Arthroscopy. 1993;9:28-32.

Wright RW, Heller MA, Quick DC, et al. Arthroscopic decompression for impinge-ment syndrome secondary to an unstable os acromiale. Arthroscopy. 2000;16:595-599.

Harris JD, Griesser MJ, Jones GL. Systematic review of the surgical treatment for symptomatic os acromiale. Int J Shoulder Surg. 2011;5:9-16.

Atoun E, Van Tongel A, Narvani A, et al. Arthroscopically assisted internal fixation of the symptomatic unstable os acromiale with absorbable screws. J Shoulder Elbow Surg. 2012;21:1740-1745.

Johnston PS, Paxton ES, Gordon V, Kraeutler MJ, Abboud JA, Williams GR. Os acromiale: a review and an introduction of a new surgical technique for management. Orthop Clin North Am. 2013;44(4):635-44. DOI: 10.1016/j.ocl.2013.06.015

Granieri GF, Bacarini L. A little-known cause of painful shoulder: Os acromiale. European radiology. 1998;8(1):130-3.

Gruber W. Überdie arten der Acromialknochen und accidentellen Acromialgelenke. Arch Anat Physiol Und wissensch Med. 1863;24:373-378.

Grant JC. Baltimore (MD): Williams & Wilkins. 1972;40.

Liberson F. Os acromiale: A contested anomaly. J Bone Joint Surg. 1937;19:683-689.

Nicholson GP, Goodman DA, Flatow EL, et al. The acromion: Morphologic condition and age related changes. A study of 420 scapulas. J Shoulder Elbow Surg. 1996;5: 1-11.

Park JG, Lee JK, Phelps CT. Os acromiale associated with rotator cuff impingement: MR imaging of the shoulder. Radiology. 1994;193(1):255-7.

Purnell JA, Bourget-Murray J, Kwapisz A, Bois AJ, Le Blanc J. Clinical results and complications following surgical management of symptomatic os acromiale: A systematic review. Journal of Orthopaedic Surgery and Research. 2019; 14(1):26.

Neer CS. 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J Bone Joint Surg Am. 1972; 54(1):41–50.