방사선학적 어깨 정렬 지표를 통한 어깨 통증 위험 예측

Prediction of Shoulder Pain Risk Using Radiographic Shoulder Alignment Parameters

Background Musculoskeletal pain involving the neck, shoulder, and low back is highly prevalent and is increasingly recognized as closely related to abnormal postural alignment. In particular, shoulder pain can arise from abnormal scapular positioning accompanied by muscular imbalance and tension. In Korea, few studies have examined whether radiographic shoulder alignment parameters can predict shoulder pain or guide clinical interventions. This study addresses this gap by exploring the association between shoulder pain and radiographic shoulder alignment parameters. Objectives To determine the impact of radiographic shoulder alignment parameters on the occurrence of shoulder pain and to assess whether shoulder malalignment serves as a risk factor, thereby informing early diagnosis and individualized treatment strategies. Methods In this retrospective study, we included 112 individuals who visited a Korean medicine hospital between January 2023 and December 2024 and underwent X-ray imaging. Shoulder-related alignment parameters were measured in a shoulder-pain group and in pain-free controls. The independent variables were radiographic shoulder alignment parameters, and the dependent variable was the presence of shoulder pain. Binary logistic regression was used for statistical analysis. Results The logistic regression analysis revealed that a decreased coracoclavicular (CC) distance [odds ratio (OR) = 0.60, p = 0.002], an increased scapulohumeral angle (OR = 1.13, p = 0.027), and an increased clavicle tilt angle (OR = 1.14, p = 0.036) were significantly associated with a higher risk of shoulder pain. Conclusions Specific radiographic alignment parameters, such as CC distance, scapulohumeral angle, and clavicle tilt angle, can serve as useful predictors for shoulder pain. These findings provide a practical reference for identifying at-risk individuals using standard radiographs for identifying at-risk individuals using standard radiographs, thereby supporting early diagnosis and the development of preventive strategies.