Ultrasound-guided percutaneous irrigation of calcific tendinopathy outside the rotator cuff: short-term evaluation

Spinnato, Paolo; Ponti, Federico; D'Agostino, Valerio; Miceli, Marco; Guerra, Enrico; Marinelli, Alessandro; Battaglia, Milva

doi:10.1007/s00256-022-04035-3

Cited by 5 publications

(1 citation statement)

References 26 publications

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“…The treatment is performed with needling and by washing the calcifications with a 0.9% sodium chloride saline solution, and can be performed with various personal techniques using one, two or three needles to inject and retrieve the fluid to dissolve the calcium deposits, depending on the friability or the degree of the softening of the deposit. Recently, this technique has also been performed in calcific tendinopathies outside the rotator cuff with excellent results in terms of pain reduction and confirming its safety [15]. Surgery (arthroscopy) is considered the last treatment option in chronic cases where conservative or less invasive approaches have failed [1,4,16].…”

Section: Introductionmentioning

confidence: 99%

Calcific Shoulder Tendinopathy (CT): Influence of the Biochemical Process of Hydrolysis of HA (Hydroxyapatite) on the Choice of Ultrasound-Guided Percutaneous Treatment (with the Three-Needle Technique)

et al. 2022

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Calcific shoulder tendinopathy (CT) is a common condition involving the central part or insertion of the rotator cuff tendons (RC) or the subacromial-subdeltoid bursa (SASD). The calcific deposits consist of poorly crystallized calcium hydroxyapatite but the mechanism of their formation still remains unclear. CT can be divided into three distinct stages, as reported by Uthhoff et al. Clinically, this condition varies with the extent of the calcification and the phase of the condition. In particular, the disorder is asymptomatic or may cause mild discomfort during the deposition of calcium, while it becomes acutely painful during the resorptive phase. US-PICT (ultrasound-guided percutaneous irrigation of calcific tendinopathy) is indicated in the acute phase (resorptive phase) of CT with significant pain relief and a very low rate of minor complications. The aim of this manuscript is to define the rationale of the ultrasound-guided percutaneous irrigation of calcific tendinopathy, correlating it with the sequence of biochemical processes that lead to the hydrolysis of hydroxyapatite. Furthermore, we will explain the reasons why we prefer using the three-needle technique for the dissolution of calcifications.

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Section: Introductionmentioning

confidence: 99%

Calcific Shoulder Tendinopathy (CT): Influence of the Biochemical Process of Hydrolysis of HA (Hydroxyapatite) on the Choice of Ultrasound-Guided Percutaneous Treatment (with the Three-Needle Technique)

et al. 2022

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A Novel Ultrasound-Guided Interventional Procedure for the Combined Treatment of Rotator Cuff Calcific Tendinopathy Complicated with Adhesive Capsulitis: The ‘Rizzoli’ Technique

Spinnato,

Masuzzo,

Tuè

et al. 2023

Academic Radiology

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US-guided percutaneous irrigation of extra-shoulder calcific tendinitis

Albano,

Viglino,

Messina

et al. 2023

British Journal of Radiology

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Objectives To investigate the efficacy and safety of ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) applied out of the shoulder, comparing its effectiveness to US-PICT of the rotator cuff. Methods Patients subjected to US-PICT for extra-shoulder calcific tendinitis (Case Group) were compared to those subjected to US-PICT of the rotator cuff (Control Group). We had pre-procedure Visual Analogue Scale (VAS) pain score, 1- and 3-month VAS of patients of the Case Group, pre-procedure and 3-month VAS of patients of the Control Group. Results The Case Group consisted of 41 patients (27 women; mean age: 45 ± 9years): 26 gluteus medius, 5 patellar tendon, 3 rectus femoris, 2 gluteus maximus, 2 common extensor tendon, 1 extensor carpi radialis longus, 1 pes anserinus, and 1 peroneus longus. The Control Group included 41 patients (27 women; mean age: 47 ± 11 years). The mean pre-procedure VAS of the Case Group was 8.8 ± 0.7 with a significant (P < .001) drop at 1 month (4.5 ± 0.6) and 3 months (3.6 ± 0.6). The mean pre-procedure VAS of the Control Group was 8 ± 1.4 and dropped to 3.1 ± 1.6 after 3 months (P < .001). Post-treatment VAS at 3 months was not significantly different between two Groups (P = 0.134). Similarly, the decrease of VAS from baseline to 3 months was not significantly different between the two Groups (P = 0.264). Conclusions US-PICT is a safe and effective procedure that can be used out of the shoulder. Advances in knowledge This study demonstrated the safety and effectiveness of US-PICT as a valuable therapeutic option for extra-shoulder calcific tendinitis, with similar clinical outcome to the same procedure performed in the rotator cuff. The technique must be adapted in some deeply located calcifications by means of the use of different needles and by thoroughly planning the access point for the procedure.

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Ultrasound-guided percutaneous irrigation of calcific tendinopathy outside the rotator cuff: short-term evaluation

Cited by 5 publications

References 26 publications

Calcific Shoulder Tendinopathy (CT): Influence of the Biochemical Process of Hydrolysis of HA (Hydroxyapatite) on the Choice of Ultrasound-Guided Percutaneous Treatment (with the Three-Needle Technique)

Calcific Shoulder Tendinopathy (CT): Influence of the Biochemical Process of Hydrolysis of HA (Hydroxyapatite) on the Choice of Ultrasound-Guided Percutaneous Treatment (with the Three-Needle Technique)

A Novel Ultrasound-Guided Interventional Procedure for the Combined Treatment of Rotator Cuff Calcific Tendinopathy Complicated with Adhesive Capsulitis: The ‘Rizzoli’ Technique

US-guided percutaneous irrigation of extra-shoulder calcific tendinitis

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