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Background <p>The humeral greater tuberosity is traditionally described as comprising three anatomical impressions: the superior, middle, and lateral impressions. The lateral or triangular impression region has been associated with the boundary between the supraspinatus and infraspinatus insertions, but this region may be indistinct in some humeri. This study defined the lateral impression anterior bony ridge (LIAB) as a ridge-based osseous landmark related to the lateral impression region, and aimed to classify its morphology and evaluate its consistency in CT-reconstructed imaging data and skeletal specimens.</p> Methods <p>A total of 447 shoulder CT datasets were retrospectively analyzed using three-dimensional humeral reconstruction. LIAB morphology was classified into three types: lateral impression type, flat type, and prominent ridge type. LIAB length was measured for quantitative analysis. To compare imaging findings with direct anatomical observations, 101 humeral greater tuberosity skeletal specimens were also examined. Interobserver and intraobserver reliability of LIAB length measurements were assessed using intraclass correlation coefficients.</p> Results <p>In the imaging dataset, the lateral impression, flat, and prominent ridge types were observed in 236 of 447 cases (52.8%), 129 of 447 cases (28.9%), and 82 of 447 cases (18.3%), respectively. In the skeletal specimens, the corresponding numbers were 51 of 101 specimens (50.5%), 23 of 101 specimens (22.8%), and 27 of 101 specimens (26.7%). The distribution of LIAB types did not differ significantly between the imaging and skeletal datasets (P = 0.129). The lateral impression type had the shortest LIAB length in both datasets (12.03 ± 1.72&#xa0;mm in imaging data; 10.61 ± 1.52&#xa0;mm in skeletal specimens), followed by the flat type (15.42 ± 2.30&#xa0;mm; 14.87 ± 1.55&#xa0;mm) and the prominent ridge type (15.90 ± 1.44&#xa0;mm; 15.89 ± 1.32&#xa0;mm). Reliability analysis showed good to excellent reproducibility, with ICC values ranging from 0.899 to 0.947 in imaging data and from 0.918 to 0.967 in skeletal specimens.</p> Conclusions <p>LIAB is a consistently identifiable ridge-based osseous landmark on the anterior aspect of the greater tuberosity. Its morphology can be classified into three types, with comparable distributions in CT-reconstructed imaging data and skeletal specimens. These findings support LIAB as a reproducible anatomical reference for describing the supraspinatus–infraspinatus boundary region on the greater tuberosity. Further clinical, arthroscopic, and imaging–surgical correlation studies are needed to clarify its relationship with rotator cuff pathology and repair planning.</p> Level of Evidence <p>Anatomical research, imaging analysis.</p>

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A study on the anatomical classification of the lateral impression anterior bony ridge on the greater tuberosity of the humerus

  • 期刊论文

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  • 发表日期：

    2026年7月18日

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  • Suwei Wang,
  • Jucheng Bai,
  • Jianwei Wang,
  • Guoqing Cui,
  • Weiguang Zhang

摘要

Background

The humeral greater tuberosity is traditionally described as comprising three anatomical impressions: the superior, middle, and lateral impressions. The lateral or triangular impression region has been associated with the boundary between the supraspinatus and infraspinatus insertions, but this region may be indistinct in some humeri. This study defined the lateral impression anterior bony ridge (LIAB) as a ridge-based osseous landmark related to the lateral impression region, and aimed to classify its morphology and evaluate its consistency in CT-reconstructed imaging data and skeletal specimens.

Methods

A total of 447 shoulder CT datasets were retrospectively analyzed using three-dimensional humeral reconstruction. LIAB morphology was classified into three types: lateral impression type, flat type, and prominent ridge type. LIAB length was measured for quantitative analysis. To compare imaging findings with direct anatomical observations, 101 humeral greater tuberosity skeletal specimens were also examined. Interobserver and intraobserver reliability of LIAB length measurements were assessed using intraclass correlation coefficients.

Results

In the imaging dataset, the lateral impression, flat, and prominent ridge types were observed in 236 of 447 cases (52.8%), 129 of 447 cases (28.9%), and 82 of 447 cases (18.3%), respectively. In the skeletal specimens, the corresponding numbers were 51 of 101 specimens (50.5%), 23 of 101 specimens (22.8%), and 27 of 101 specimens (26.7%). The distribution of LIAB types did not differ significantly between the imaging and skeletal datasets (P = 0.129). The lateral impression type had the shortest LIAB length in both datasets (12.03 ± 1.72 mm in imaging data; 10.61 ± 1.52 mm in skeletal specimens), followed by the flat type (15.42 ± 2.30 mm; 14.87 ± 1.55 mm) and the prominent ridge type (15.90 ± 1.44 mm; 15.89 ± 1.32 mm). Reliability analysis showed good to excellent reproducibility, with ICC values ranging from 0.899 to 0.947 in imaging data and from 0.918 to 0.967 in skeletal specimens.

Conclusions

LIAB is a consistently identifiable ridge-based osseous landmark on the anterior aspect of the greater tuberosity. Its morphology can be classified into three types, with comparable distributions in CT-reconstructed imaging data and skeletal specimens. These findings support LIAB as a reproducible anatomical reference for describing the supraspinatus–infraspinatus boundary region on the greater tuberosity. Further clinical, arthroscopic, and imaging–surgical correlation studies are needed to clarify its relationship with rotator cuff pathology and repair planning.

Level of Evidence

Anatomical research, imaging analysis.