Sonographically Guided Percutaneous Needle Lavage in Calcific Tendinitis of the Shoulder: Short- and Long-Term Results

Rodríguez, J.L. del Cura; Torre, Iñaki; Zabala, Rosa; Legórburu, Ana

doi:10.2214/ajr.07.2254

Cited by 166 publications

(138 citation statements)

References 24 publications

(57 reference statements)

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“…1). This technique, which in past years was performed under fluoroscopic guidance, can significantly reduce the volume of calcifications and produce functional and clinical improvement [22,23].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous ultrasound-guided treatment of shoulder tendon calcifications: Clinical and radiological follow-up at 6 months

Conti¹,

Marchioro²,

Dorigo

et al. 2010

Journal of Ultrasound

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Introduction: Calcific tendinitis of the shoulder is a common condition characterized by chronic pain and/or very painful acute episodes. Different treatments are used during painful flare-up, but they are often ineffective. US-guided percutaneous needle aspiration/ lavage is proving to be an effective means for eliminating these calcifications. Materials and methods: We treated 123 consecutive patients (mean age 48 years) with calcific tendinitis of the shoulder. Fifty-five patients had persistent symptoms requiring 2 or more treatments with lavage and intrabursal steroid infiltration. Before and after treatment, US studies were done independently by 2 radiologists with experience in musculoskeletal ultrasound. Results were concordant in over 90% of the cases. Constant Shoulder Scores were calculated before and 6 months after treatment. At 6 months, MRI was performed to identify impingement and/or bursitis. Results: Post-treatment Constant scores were significantly improved in all 68 patients treated once (Group 1: mean scores 28.6 vs. 81.4) and in 52 of the 55 treated twice or more (Group 2: mean scores 34.1 vs. 71.1) (p < 0.0001 in both cases). Pretreatment Constant scores were similar in patients with and without shoulder impingement on MRI (31.2 vs. 30.9, respectively), but after treatment the impingement group's scores were significantly higher (82.2 vs. 73.3, respectively; p < 0.001). Conclusions: US-guided percutaneous needle aspiration/lavage is an effective and economic treatment for calcific tendinitis of the shoulder. Pretreatment MRI should be done to check for impingement since it is often associated with an incomplete response to the first treatment. Sommario Introduzione: La tendinopatia calcifica di spalla è una condizione relativamente frequente caratterizzata, quando sintomatica, da dolore cronico e da fasi di dolore acuto molto intenso. Materiali e metodi: Da ottobre 2006 a marzo 2008 abbiamo trattato 126 spalle di 125 pazienti consecutivi. Tutti hanno eseguito Rx ed ecografia prima del trattamento ed il test di Constant prima del trattamento e a 6 mesi di distanza. 55 pazienti su 123 (42%) sono stati trattati due o più volte con infiltrazione intrabursale di corticosteroide. Tre pazienti hanno rifiutato altri trattamenti dopo il primo. Sono stati quindi raccolti i dati complessivamente di 123 spalle. È stata eseguita RM di controllo a sei mesi. Risultati: Incremento del Constant Score dopo la procedura in tutti i pazienti trattati una sola volta ed in quasi tutti i pazienti trattati due volte; i pazienti sono stati divisi in due classi, rispettivamente trattati una o due (o più) volte. In ciascuna delle due classi c'è stato un significativo incremento (p < 0,0001)delle medie dei Cs pre e post trattamento; nella classe dei pazienti trattati due volte significatività statistica (p < 0,0001) tra le medie dei Cs rispettivamente prima del trattamento iniziale e dopo il primo trattamento, e tra la media Cs di quest'ultimo e quella dopo 6 mesi dal primo trattamento. Il Cs dopo il trattamen...

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Section: Introductionmentioning

confidence: 99%

Percutaneous ultrasound-guided treatment of shoulder tendon calcifications: Clinical and radiological follow-up at 6 months

Conti¹,

Marchioro²,

Dorigo

et al. 2010

Journal of Ultrasound

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“…10,12 Percutaneous treatment is not indicated if the calcification is asymptomatic, is very small (,5 mm), has migrated into the bursal space or is eroding the humeral cortical bone. 26 Since the first study performed by Farin et al, different techniques and approaches have been reported in the literature 12,15,17,23,27,28 using one or two needles of different sizes to remove calcium. To date, no evidence exists in favour of using a specific size or number of needles.…”

Section: Treatment Of Calcific Tendinopathy Of the Rotator Cuffmentioning

confidence: 99%

Ultrasound-guided interventional procedures around the shoulder

Messina¹,

Banfi²,

Orlandi³

et al. 2016

BJR

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“…These techniques may utilize two needles 24,41,42 or one. [43][44][45][46][47][48] The technique is often performed as follows ( Fig. 3 and 4 At that point, the needle is either drawn back into the subacromial bursa, or is completely withdrawn and a new needle is inserted into the subacromial bursa.…”

Section: Injectionsmentioning

confidence: 99%

“…47 The ability to remove more calcium during the procedure does not result in better pain relief 42 and a decrease in calcium deposit size is seen regardless of initial ability to remove all calcium from the deposit. 43,45 Removal of calcium may not even be necessary to provide pain relief. 52 …”

Section: Injectionsmentioning

confidence: 99%