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Clinical Outcomes of Ultrasound-Guided Aspiration and Lavage in Calcific Tendinosis of the Shoulder

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HSS Journal

Abstract

Objective

To determine the effectiveness of ultrasound-guided aspiration and lavage in the treatment of patients with calcific tendinosis of the shoulder.

Materials and methods

Retrospective chart review resulted in 44 patients who were identified as having received ultrasound-guided aspiration of calcific tendinosis of the shoulder between 2000 and 2003. Of these, 36 patients were interviewed by telephone for pre- and posttreatment assessment of pain, shoulder function, prior shoulder surgery, injury, and prescribed treatment modalities with a follow-up time of 8 months to 3.1 years (mean = 22.5 months). L’Insalata score, numeric rating scale (NRS), and patient satisfaction score served as outcome measures.

Results

Our criteria for a successful outcome included (1) 12-point or greater improvement in the L’Insalata shoulder rating questionnaire, (2) 2-point or greater improvement in the NRS, (3) patient satisfaction rating of “good”, “very good”, or “excellent”, (4) patients’ willingness to undergo the procedure again if they experienced recurrent symptoms, and (5) 1 month or less of analgesic medication use after the aspiration procedure. We determined that ultrasound-guided aspiration of calcific tendinosis of the shoulder resulted in a successful outcome for 75% (27/36) of patients with a mean 20.2-point improvement in the L’Insalata shoulder rating questionnaire score and a mean 6.4-point improvement in the NRS (p < 0.01). Conclusion: This retrospective study suggests that ultrasound-guided aspiration and lavage of calcific shoulder deposits appears to be an efficacious therapeutic modality for treatment of calcific tendinosis. Further studies involving prospective randomized controlled trials would be helpful to further assess the long-term efficacy of this procedure as a minimally invasive treatment for calcific tendinosis of the shoulder.

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References

  1. Plenck H (1952) Calcifying tendinosis of the shoulder. Radiology 59:384–389

    Google Scholar 

  2. Uhthoff HK, Loehr JW (1997) Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis and management. J Am Acad Orthop Surg 5(4):183–191

    PubMed  Google Scholar 

  3. Welfling J, Kahn MF, Desroy M, Paologgi JB, De Seze S (1965) Calcification of the shoulder. The disease of multiple tendinous calcifications. Rev Rheumatology 32:325–334

    CAS  Google Scholar 

  4. Ruttimann G, Uber (1959) Die Haufigkeit rontenologischer Veranderungen bei Patienten mit typischer Periarthritis humeroscapularis und Schultergesunden. Inaugural dissertation. University of Zurich, Zurich, Switzerland

  5. Speed CA, Hazelman BL (1999) Calcific tendinosis of the shoulder. N Engl J Med 340(20):1582–1584

    Article  PubMed  CAS  Google Scholar 

  6. Rokito AS, Loebenberg MI (1999) Frozen shoulder and calcific tendinosis. Curr Opin Orthop 10(4):294–304

    Article  Google Scholar 

  7. Chevriere A, Carlier R, Feydy A, Mompoint D, Bayou E, Vallee C (2000) Imaging-guided needle puncture, infiltration and lavage of rotator cuff calcifications. Retrospective evaluation of 50 cases of treated periarthritis. [French] J Radiol 81(9):971–974

    PubMed  CAS  Google Scholar 

  8. Pfister J, Gerber H (1997) Chronic calcifying tendinosis of the shoulder—therapy by percutaneous needle aspiration and lavage: a prospective open study of 62 shoulders. Clin Rheumatol 16(3):269–274

    Article  PubMed  CAS  Google Scholar 

  9. Comfort TH, Arafiles R (1978) Barbotage of the shoulder with image-intensified fluoroscopic control of needle placement for calcific tendinosis. Clin Orthop 135:171–178

    PubMed  Google Scholar 

  10. Adler RS, Sofka CM (2003) Percutaneous ultrasound-guided injections in the musculoskeletal system. Ultrasound Q 19(1):3–12

    Article  PubMed  Google Scholar 

  11. Farin PU, Jaroma H, Soimakallio S (1995) Rotator cuff calcifications: treatment with ultrasound-guided technique. Radiology 195:841–843

    PubMed  CAS  Google Scholar 

  12. Giacomoni P, Siliotto R (1999) Echo-guided percutaneous treatment of chronic calcific tendinosis of the shoulder. [Italian] Radiol Med (Torino) 98:386–390

    CAS  Google Scholar 

  13. Farin PU, Rasanen H, Jaroma H, Harju A (1996) Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skelet Radiol 25:551–554

    Article  CAS  Google Scholar 

  14. Aina R, Cardinal E, Bureau NJ, Aubin B, Brassard P (2001) Calcific shoulder tendinosis: treatment with modified US-guided fine-needle technique. Radiology 221:455–461

    Article  PubMed  CAS  Google Scholar 

  15. L’Insalata JC, Warren RF, Cohen SB, Altchek DW, Peterson MGE (1997) A self-administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Jt Surg 79-A(5):738–748

    Google Scholar 

  16. Gschwend N, Patte D, Zippel J (1972) Therapy of calcific tendinosis of the shoulder. [German] (Die Therapie der Tendinosis calcarea des Schultergelenks). Arch Orthop Trauma Surg 73(2):120–135

    CAS  Google Scholar 

  17. Gazielly D, Bruyere G, Gleyze P, Thomas T (1997) Open acromioplasty with excision of calcium deposits and tendon suture. In: Gazielly D, Gleyze P, Thomas T (eds) The cuff. Elsevier, Paris, pp 172–175

    Google Scholar 

  18. Mole D, Kempf J, Gleyze P, Rio B, Bonnomet F, Walch F (1993) Results of arthroscopic treatment of tendinosis of the rotator cuff of the shoulder. Second part: calcified lesions of the rotator cuff. Rev Chir Orthop Repar Apar Mot 79:532–541

    CAS  Google Scholar 

  19. Ark JW, Flock TJ, Flatow EL, Bigliani LU (1992) Arthroscopic treatment of calcific tendinosis of the shoulder. Arthroscopy 8:183–188

    Article  PubMed  CAS  Google Scholar 

  20. Bosworth BM (1941) Calcium deposits in shoulder and subacromial bursitis: Survey of 122 shoulders. JAMA 116:2477–2482

    Google Scholar 

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Authors and Affiliations

Authors

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Correspondence to Ronald S. Adler PhD, MD.

Additional information

This study was performed by the Departments of Physiatry and of Radiology and Imaging, Hospital for Special Surgery, New York, NY.

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Lin, J.T., Adler, R.S., Bracilovic, A. et al. Clinical Outcomes of Ultrasound-Guided Aspiration and Lavage in Calcific Tendinosis of the Shoulder. HSS Jrnl 3, 99–105 (2007). https://doi.org/10.1007/s11420-006-9037-9

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  • DOI: https://doi.org/10.1007/s11420-006-9037-9

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