Fig. (5) Measuring scapular elevation to quantitate extent of SHEAR deformity. An anterior 3D-CT is used to measure scapular elevation. The area of each portion of both scapulas is measured as indicated (areas A-D). The area above the scapula is divided by the total scapular area and corrected for rotational artifacts by subtraction of the unaffected side from the affected side before multiplying by 100 to obtain percent elevation. Shown is the CT of a patient who was calculated to have 37% scapular elevation. Reproduced from Nath RK, Somasundaram C, Melcher SE, Bala M, Wentz MJ: Arm rotated medially with supination - the ARMS variant: description of its surgical correction. BMC Musculoskelet Disord 2009, 10: 32.