Causation and management of calcific tendonitis and periarthritis

Carcia, Christopher R.; Scibek, Jason S.

doi:10.1097/bor.0b013e32835d4e85

Cited by 28 publications

(16 citation statements)

References 39 publications

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“…In contrast with our initial hypothesis, ESWT did not show a better outcome in calcific lateral epicondylopathy than in noncalcific lateral epicondylopathy. This result was not consistent with the results of previous studies, which stated that the resorption of calcifications was important in determining whether ESWT would be effective [ 20 21 ]. Considering that the response of calcific rotator cuff tendinitis to ESWT is different from the response of calcific lateral epicondylopathy to ESWT, there might be a difference in the role of calcification between calcific rotator cuff tendinitis and calcific lateral epicondylopathy.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of Therapeutic Effect of Extracorporeal Shock Wave in Calcific Versus Noncalcific Lateral Epicondylopathy

2016

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ObjectiveTo assess the therapeutic effect of extracorporeal shock wave therapy (ESWT) in lateral epicondylopathy with calcification, and compare it to the effect of ESWT in lateral epicondylopathy without calcification.MethodsA retrospective study was conducted. Forty-three patients (19 with calcific and 24 with noncalcific lateral epicondylopathy in ultrasound imaging) were included. Clinical evaluations included the 100-point score, Nirschl Pain Phase scale before and after ESWT, and Roles and Maudsley (R&M) scores after ESWT. ESWT (2,000 impulses and 0.06–0.12 mJ/mm2) was performed once a week for 4 weeks.ResultsThe 100-point score and Nirschl Pain Phase scale changed significantly over time (p<0.001), but there was no significant difference between groups (p=0.555). The R&M scores at 3 and 6 months after ESWT were not significantly different between groups. In the presence of a tendon tear, those in the calcific lateral epicondylopathy group showed poor improvement of 100-point scores compared to the noncalcific group (p=0.004).ConclusionThis study demonstrated that the therapeutic effect of ESWT in calcific lateral epicondylopathy was not significantly different from that in noncalcific lateral epicondylopathy. When a tendon tear is present, patients with calcific lateral epicondylopathy might show poor prognosis after ESWT relative to patients with noncalcific lateral epicondylopathy.

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Section: Discussioncontrasting

confidence: 99%

Comparison of Therapeutic Effect of Extracorporeal Shock Wave in Calcific Versus Noncalcific Lateral Epicondylopathy

2016

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“…For instance, calcific tendonitis is characterized by recurrent painful episodes. 8 Given the low prevalence of full-thickness tears, unnecessary referrals to secondary care can be prevented. Patients with an inflammatory disorder, such as bursitis or calcifications in the resorption phase, may benefit from corticosteroid injections.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Imaging for Tailored Treatment of Patients With Acute Shoulder Pain

Ottenheijm

Cals

Weijers

et al. 2015

The Annals of Family Medicine

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PURPOSE:The objective of this study was to assess the frequencies of ultrasound findings in patients with acute rotator cuff disorders in family medicine. METHODS:In a prospective observational study, 129 patients aged 18 to 65 years with acute shoulder pain in whom the family physician suspected rotator cuff disease underwent ultrasound imaging. RESULTS:Rotator cuff disease was present in 81% of the patients, and 50% of them had multiple disorders. Calcific tendonitis was the most frequently diagnosed specific disorder. An age of 40 years or older was most strongly related to rotator cuff disease. CONCLUSIONS:Ultrasound imaging enables family physicians to rationalize treatment in nearly all patients who are aged 40 years and older with acute shoulder pain. INTRODUCTIONA lthough most patients with acute shoulder pain are cared for in family medicine, 1 physical examinations used to evaluate the extensive spectrum of rotator cuff disease are often inadequate.2 As a result, recommended treatment for all patients in family medicine consists of stepwise treatment regardless of the specific underlying cause. 3,4The disadvantage of this management approach is that it may lead to unnecessary interventions and a delay in specific treatment, with subsequent prolonged recovery. Ultrasound imaging of the shoulder has become an accepted diagnostic modality for evaluating rotator cuff disorders, 5 which potentially allows for more tailored treatment based on diagnostic subgroups. Against this background, it seemed useful to prospectively determine the frequencies of the disorders from the spectrum of rotator cuff disease in patients with shoulder pain in a family medicine setting. The objectives of this study were to assess prospectively the frequencies of specific findings as diagnosed using ultrasound imaging in patients with acute shoulder pain, and to identify possible predictors of shoulder pain. METHODSThe present study was part of the Maastricht Ultrasound Shoulder Pain Trial (MUST) study, a randomized controlled trial among patients in family medicine with acute shoulder pain. The design of the MUST study has been presented in detail elsewhere. 6 We included 129 patients with acute shoulder pain in whom the family physician suspected rotator cuff disease. Patients were eligible if they (1) had shoulder pain upon abduction with painful arc, (2) had symptoms having lasted for fewer than 3 months, (3) had no other episodes of shoulder pain in the previous 12 months, (4) were aged between 18 and 65 years.All ultrasound examinations were obtained in real time using a Phillips IU22 (Phillips Medical Systems) with a 5-12 MHz broadband linear-array transducer (Phillips L12-5). All examinations were performed by experienced musculoskeletal radiologists at the Orbis Medical Centre, The Netherlands, using a protocol-based scanning approach. Standardized ultrasound diagnostic criteria for pathology were used. 6 Ultrasound findings were prospectively evaluated for abnormalities of the rotator cuff, the long head of the...

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“…Calcific tendinopathies of the shoulder are due to inflammation around deposits of calcium hydroxyapatite crystals [1–8] within periarticular tendineal structures. These conditions represent 6.8% of all painful shoulders.…”

Section: Introductionmentioning

confidence: 99%