Wayne, NJ, March 1, 2023 – A study by Emory Healthcare reports that Konica Minolta Healthcare’s Dynamic Digital Radiography (DDR), an enhanced version of a standard X-ray system that captures motion, provides more quantitative information on shoulder motion and a greater understanding of the injury and postoperative improvement than static imaging alone. Angel X. Xiao, MD, led the team of researchers to explore the “Variation in Scapulohumeral Rhythm on Dynamic Radiography in Pathologic Shoulders: A Novel Diagnostic Tool,” published in the Journal of Shoulder and Elbow Surgery. The team also found DDR is a reproducible method to quantify and compare the scapulohumeral rhythm (SHR), enabling clinicians to visualize both the pattern and extent of motion impairment in the shoulder, which varies across different types of injuries and pathologies.
“With DDR, we can very clearly see how structures move in relation to one another in the shoulder anatomy in a way we’ve never been able to see before – both when it is moving and at a particular time point,” says Eric R Wagner, MD, MSc, Assistant Professor in the Department of Orthopaedics at Emory University and Director of Upper Extremity Research at Emory Healthcare. “We can obtain more critical information from this dynamic motion analysis using DDR, and that is an inherent advantage for both diagnosis and post-surgical treatment monitoring.”
DDR is the next evolution in X-ray, helping to enhance diagnosis and management of diseases and injuries, including many orthopedic conditions. DDR enables clinicians to visualize the dynamic interaction of anatomical structures, such as tissue and bone, with physiological changes over time. DDR is not fluoroscopy; it is a series of individual digital images acquired at high speed and low dose. In the same study, clinicians can acquire static and dynamic images.

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In the study, 121 patients underwent a DDR exam to assess arm motion, beginning with the arm at rest by the patient’s side and then proceeding to maximal abduction, or with the arm raised away from the body. Using the DDR imaging data, humeral abduction, scapular upward rotation and scapulohumeral rhythm were all quantified. Differences in SHR were identified using multivariate linear regression between normal controls and patients with pathologic conditions.
Although SHR has been studied observationally since the 1930's, inter-pathological comparisons in the literature are scarce. The study reported that DDR makes it possible to cost-effectively and reproducibly assess shoulder motion. DDR was also found to be a reliable and efficient method for quantifying the severity of motion aberrancies in an array of shoulder pathologies. Additionally, the authors wrote that DDR is “a simple-to-operate technology that can be realistically implemented into the clinical workflow.”