Validity of measuring humeral torsion using palpation of bicipital tuberosities

Abstract

The magnitude of humeral torsion (HT) affects the internal and external rotation range of motion at the shoulder. Currently imaging is required to quantify the HT angle, however, factors such as cost and non-availability of imaging to musculoskeletal clinicians limits its use. The aim of this study was to examine the validity of palpation of the bicipital tuberosities as an alternative to imaging for quantifying HT angles. The bicipital-forearm angle, an indirect measure of HT, was measured using palpation and real-time ultrasound imaging in 25 subjects. The agreement among the two methods was excellent with the Intraclass Correlation Coefficient (3,k)  =  0.92, and the mean difference between the two methods was −0.2° (SD 4.1°) with 95% limits of agreement of −8.3° to 7.9°. Pearson's correlation coefficient (r) among the two methods was 0.85. In a clinical setting, palpation appears to be a practical alternative to US imaging for measuring HT.

Acknowledgments

The authors thank Dr Deborah Givens for the ultrasound unit and Mr Oren Costantini for helping with data collection. Dr Borstad receives funding from the National Institute of Child Health and Human Development; Award no. K01HD052797.

Declaration of interest: The authors report no declaration of interest.