An os acromiale is a persistent accessory ossification centre of the lateral acromion.
- It's normal to see the accessory ossification centre until around 15 years of age.
- But there should be complete fuse by 25.
- If there is non fusion and a persistent os after 25, it's termed an os acromiale.
It may be completely asymptomatic but there are two potential complications.
- Impingement on the Rotator Cuff tendons.
- Acromial apophysiolysis.
- There can be abnormal movement between the acromion and the OS Acromiale.
- This results in the OS moving inferiorly & impinging on the RCT.
- Additionally, if there is malalignment between the OS and the Clavicle, this can lead to narrowing of the subacromial space.
- For acromial apophysiolysis, we will look at this specifically in the next post.
- So how do you best recognise an Os Acromiale on Shoulder MRI.
- Its easy to miss if you don’t look for it specifically and the key is to look at the axial scans where it is most obvious.
- You can see it on coronal images but it's much harder and sagittals are not much help.
- See the video below which demonstrates how to find an os acromiale on MRI Shoulder.
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