HSS Journal

, Volume 3, Issue 1, pp 99–105

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

  • Julie T. Lin
  • Ronald S. Adler
  • Ana Bracilovic
  • Grant Cooper
  • Carolyn Sofka
  • Gregory E. Lutz
Original Article

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.

Key words

ultrasound-guidance aspiration lavage calcification shoulder tendinosis 

References

  1. 1.
    Plenck H (1952) Calcifying tendinosis of the shoulder. Radiology 59:384–389Google Scholar
  2. 2.
    Uhthoff HK, Loehr JW (1997) Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis and management. J Am Acad Orthop Surg 5(4):183–191PubMedGoogle Scholar
  3. 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 32:325–334Google Scholar
  4. 4.
    Ruttimann G, Uber (1959) Die Haufigkeit rontenologischer Veranderungen bei Patienten mit typischer Periarthritis humeroscapularis und Schultergesunden. Inaugural dissertation. University of Zurich, Zurich, SwitzerlandGoogle Scholar
  5. 5.
    Speed CA, Hazelman BL (1999) Calcific tendinosis of the shoulder. N Engl J Med 340(20):1582–1584PubMedCrossRefGoogle Scholar
  6. 6.
    Rokito AS, Loebenberg MI (1999) Frozen shoulder and calcific tendinosis. Curr Opin Orthop 10(4):294–304CrossRefGoogle Scholar
  7. 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):971–974PubMedGoogle Scholar
  8. 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):269–274PubMedCrossRefGoogle Scholar
  9. 9.
    Comfort TH, Arafiles R (1978) Barbotage of the shoulder with image-intensified fluoroscopic control of needle placement for calcific tendinosis. Clin Orthop 135:171–178PubMedGoogle Scholar
  10. 10.
    Adler RS, Sofka CM (2003) Percutaneous ultrasound-guided injections in the musculoskeletal system. Ultrasound Q 19(1):3–12PubMedCrossRefGoogle Scholar
  11. 11.
    Farin PU, Jaroma H, Soimakallio S (1995) Rotator cuff calcifications: treatment with ultrasound-guided technique. Radiology 195:841–843PubMedGoogle Scholar
  12. 12.
    Giacomoni P, Siliotto R (1999) Echo-guided percutaneous treatment of chronic calcific tendinosis of the shoulder. [Italian] Radiol Med (Torino) 98:386–390Google Scholar
  13. 13.
    Farin PU, Rasanen H, Jaroma H, Harju A (1996) Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skelet Radiol 25:551–554CrossRefGoogle Scholar
  14. 14.
    Aina R, Cardinal E, Bureau NJ, Aubin B, Brassard P (2001) Calcific shoulder tendinosis: treatment with modified US-guided fine-needle technique. Radiology 221:455–461PubMedCrossRefGoogle Scholar
  15. 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):738–748Google Scholar
  16. 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):120–135Google Scholar
  17. 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 172–175Google Scholar
  18. 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 79:532–541Google Scholar
  19. 19.
    Ark JW, Flock TJ, Flatow EL, Bigliani LU (1992) Arthroscopic treatment of calcific tendinosis of the shoulder. Arthroscopy 8:183–188PubMedCrossRefGoogle Scholar
  20. 20.
    Bosworth BM (1941) Calcium deposits in shoulder and subacromial bursitis: Survey of 122 shoulders. JAMA 116:2477–2482Google Scholar

Copyright information

© Springer Verlag 2006

Authors and Affiliations

  • Julie T. Lin
    • 1
    • 2
  • Ronald S. Adler
    • 3
    • 4
  • Ana Bracilovic
    • 1
    • 2
  • Grant Cooper
    • 1
    • 2
  • Carolyn Sofka
    • 3
    • 4
  • Gregory E. Lutz
    • 1
    • 2
  1. 1.Physiatry DepartmentHospital for Special SurgeryNew YorkUSA
  2. 2.Department of Rehabilitation MedicineWeill Medical College of Cornell UniversityNew YorkUSA
  3. 3.Division of Ultrasound and Body CT Department of Radiology and ImagingHospital for Special SurgeryNew YorkUSA
  4. 4.Radiology DepartmentWeill Medical College of Cornell UniversityNew YorkUSA

Personalised recommendations