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US-guided percutaneous treatment and physical therapy in rotator cuff calcific tendinopathy of the shoulder: outcome at 3 and 12 months

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Abstract

Objectives

To monitor the results of ultrasound (US)-guided percutaneous treatment of calcific tendinopathy of the shoulder at 12 months (T12) after treatment (T0). To verify the possible relations between some pre- and post-procedural variables with the clinical outcome at T12.

Methods

Forty-seven patients (26 female and 21 male) were enrolled in the study. Patients' approval and written informed consent were obtained. Symptoms were assessed by Constant Shoulder Score (CSS) at T0 and T12. Thirty of these also underwent a CSS control at 3 months (T3). The treatment efficacy was statistically tested for relation with location and type of calcification, characteristics of the tendon and subdeltoid bursa, impingement, and rehabilitation treatments.

Results

There was a significant increase in the average CSS value between T0 and T12 (40.7 vs. 75.3). The variables analysed did not show a statistically significant effect on the outcome at T12. A link was noticed only between patients' increasing age and score improvement, particularly among female subjects.

Conclusion

US-guided treatment of calcific tendonitis is a viable therapeutic option. No pre- or intra-procedural parameters emerged which might help in predicting the outcome, apart from patients' needs in everyday life.

Key points

US-guided tcreatment of shoulder calcific tendinopathy is an excellent therapeutic option

Long-term results seem greatly affected by patients’ features and needs in everyday life

No proven pre- or intra-procedural parameters emerged that might predict the outcome

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Abbreviations

SADB:

subacromial subdeltoid bursa

CSS:

Constant Shoulder Score

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Acknowledgments

The scientific guarantor of this publication is Giorgio De Conti, MD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Vincenzo Baldo and Silvia Cocchio kindly provided statistical advice for this manuscript. Institutional Review Board approval was not required. Patients' approval was obtained in order to enrol them in the study, and it was considered sufficient since the study was not intended to modify the patients' treatment in any way. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution.

Author information

Correspondence to Giulio Pasquotti.

Electronic supplementary material

Below is the link to the electronic supplementary material.

(MPG 3938 kb)

Fibroadhesive subdeltoid bursa. The bursa is very thickened. Bursal distension in this case is only partial and not uniform, with many synovial laciniae that impede normal diffusion of the injected saline solution. (MPG 6640 kb)

Fibroadhesive subdeltoid bursa. The bursa is very thickened. Bursal distension in this case is only partial and not uniform, with many synovial laciniae that impede normal diffusion of the injected saline solution. (MPG 3836 kb)

Video 1

(MPG 3938 kb)

Video 2

Elastic subdeltoid bursa. Prompt distension of the bursa is shown, which does not appear significantly thickened or with definite thickened septa inside. (MPG 650 kb)

Video 3

Fibroadhesive subdeltoid bursa. The bursa is very thickened. Bursal distension in this case is only partial and not uniform, with many synovial laciniae that impede normal diffusion of the injected saline solution. (MPG 6640 kb)

Video 4

Fibroadhesive subdeltoid bursa. The bursa is very thickened. Bursal distension in this case is only partial and not uniform, with many synovial laciniae that impede normal diffusion of the injected saline solution. (MPG 3836 kb)

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Pasquotti, G., Faccinetto, A., Marchioro, U. et al. US-guided percutaneous treatment and physical therapy in rotator cuff calcific tendinopathy of the shoulder: outcome at 3 and 12 months. Eur Radiol 26, 2819–2827 (2016) doi:10.1007/s00330-015-4102-8

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Keywords

  • Calcific tendinitis of the shoulder
  • US-guided percutaneous treatment
  • Shoulder impingement
  • Subacromial bursal thickening
  • Rehabilitation