Skeletal Radiology

, Volume 42, Issue 1, pp 19–24 | Cite as

Double-needle ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis: tips & tricks

  • Luca Maria Sconfienza
  • Sara Viganò
  • Chiara Martini
  • Alberto Aliprandi
  • Pietro Randelli
  • Giovanni Serafini
  • Francesco Sardanelli
Review Article


Rotator cuff calcific tendinitis is a very common disease and may result in a very painful shoulder. Aetiology of this disease is still poorly understood. When symptoms are mild, this disease may be treated conservatively. Several treatment options have been proposed. Among them, ultrasound-guided procedures have been recently described. All procedures use one or two needles to inject a fluid, to dissolve calcium and to aspirate it. In the present article, we review some tips and tricks that may be useful to improve performance of an ultrasound-guided double-needle procedure.


Shoulder Rotator cuff calcific tendinitis Ultrasound-guided procedures 


  1. 1.
    Speed CA, Hazelman BL. Calcific tendinitis of the shoulder. N Engl J Med. 1999;340:1582–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment–nonrandomized controlled trial. Radiology. 2009;252:157–64.PubMedCrossRefGoogle Scholar
  3. 3.
    Uhthoff HK, Sarkar K. Calcifying tendinitis. Baillieres Clin Rheumatol. 1989;3:567–81.PubMedCrossRefGoogle Scholar
  4. 4.
    Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am. 2005;87:187–202.PubMedCrossRefGoogle Scholar
  5. 5.
    Bianchi S, Martinoli C, Shoulder in Bianchi S, Martinoli C, eds. Ultrasound of the musculoskeletal system, Berlin, Germany: Springer-Verlag, 2007;190–331Google Scholar
  6. 6.
    Hamada J, Ono W, Tamai K, Saotome K, Hoshino T. Analysis of calcium deposits in calcific periarthritis. J Rheumatol. 2001;28:809–13.PubMedGoogle Scholar
  7. 7.
    Leduc BE, Caya J, Tremblay S, Bureau NJ, Dumont M. Treatment of calcifying tendinitis of the shoulder by acetic acid iontophoresis: a double-blind randomized controlled trial. Phys Med Rehabil. 2003;84:1523–7.CrossRefGoogle Scholar
  8. 8.
    Ebenbichler G. Ultrasound therapy for calcific tendinitis of the shoulder. N Engl J Med. 1999;340:1582–4.CrossRefGoogle Scholar
  9. 9.
    Mouzopoulos G, Stamatakos M, Mouzopoulos D, Tzurbakis M. Extracorporeal shock wave treatment for shoulder calcific tendonitis: a systematic review. Skeletal Radiol. 2007;36:803–11.PubMedCrossRefGoogle Scholar
  10. 10.
    Wittenberg RH. Surgical or conservative treatment for chronic rotator cuff calcifying tendinitis—a matched-pair analysis of 100 patients. Arch Orthop Trauma Surg. 2001;121:56–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Rubenthaler F. Prospective randomized surgical treatments for calcifying tendinopathy. Clin Orthop Relat Res. 2003;410:278–84.PubMedCrossRefGoogle Scholar
  12. 12.
    Comfort TH, Arafiles RP. Barbotage of the shoulder with image-intensified fluoroscopic control of needle placement for calcific tendinitis. Clin Orthop Relat Res. 1978;135:171–8.PubMedGoogle Scholar
  13. 13.
    Bradley M, Bhamra MS, Robson MJ. Ultrasound guided aspiration of symptomatic supraspinatus calcific deposits. Br J Radiol. 1995;68:716–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Galletti S, Magnani M, Rotini R, et al. The echo-guided treatment of calcific tendinitis of the shoulder. Chir Organi Mov. 2004;89:319–23.PubMedGoogle Scholar
  15. 15.
    Aina R, Cardinal E, Bureau NJ, Aubin B, Brassard P. Calcific shoulder tendinitis: treatment with modified US-guided fine-needle method. Radiology. 2001;221:455–61.PubMedCrossRefGoogle Scholar
  16. 16.
    Farin PU, Rasanen H, Jaroma H, Harju A. Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skeletal Radiol. 1996;25:551–4.PubMedCrossRefGoogle Scholar
  17. 17.
    del Cura JL, Torre I, Zabala R. Legórburu A Sonographically guided percutaneous needle lavage in calcific tendinitis of the shoulder: short- and long-term results. AJR Am J Roentgenol. 2007;189:W128–34.PubMedCrossRefGoogle Scholar
  18. 18.
    Sconfienza LM, Serafini G, Sardanelli F. Treatment of calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique. AJR Am J Roentgenol. 2011;197:W366.PubMedCrossRefGoogle Scholar
  19. 19.
    Giacomoni P, Siliotto R. Echo-guided percutaneous treatment of chronic calcific tendinitis of the shoulder. Radiol Med (Torino). 1999;98:386–90.Google Scholar
  20. 20.
    Farin PU, Jaroma HJ. Sonographic findings of rotator cuff calcifications. J Ultrasound Med. 1995;14:7–14.PubMedGoogle Scholar
  21. 21.
    Sconfienza LM, Bandirali M, Serafini G, et al. Rotator Cuff Calcific Tendinitis: Does Warm Saline Solution Improve the Short-term Outcome of Double-Needle US-guided Treatment? Radiology. 2012;262:560–6.PubMedCrossRefGoogle Scholar
  22. 22.
    De Zordo T, Ahmad N, Ødegaard F, et al. US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons. Ultraschall Med. 2011;32:S117–23.PubMedCrossRefGoogle Scholar
  23. 23.
    Fowler C, McCracken D. US probes—Risk of cross infection and ways to reduce it—Comparison of cleaning methods. Radiology. 1999;213:299–300.PubMedGoogle Scholar
  24. 24.
    Weidner S, Kellner W, Kellner H. Interventional radiology and the musculoskeletal system. Best Pract Res Clin Rheumatol. 2004;18:945–56.PubMedCrossRefGoogle Scholar
  25. 25.
    Caturelli E, Giacobbe A, Facciorusso D, et al. Free-hand technique with ordinary antisepsis in abdominal US-guided fine-needle punctures: three-year experience. Radiology. 1996;199:721–3.PubMedGoogle Scholar
  26. 26.
    Niesel HC. Local anesthetics: maximum recommended doses. Anaesthesiol Reanim. 1997;22:60–2.PubMedGoogle Scholar
  27. 27.
    De Smet AA. Ultrasound-guided injections and aspirations of the extremities. Semin Roentgenol. 2004;39:145–54.PubMedCrossRefGoogle Scholar
  28. 28.
    del Cura JL. Ultrasound-guided therapeutic procedures in the musculoskeletal system. Curr Probl Diagn Radiol. 2008;37:203–18.PubMedCrossRefGoogle Scholar
  29. 29.
    Wiberg E, Wiberg N, Holleman AF. Inorganic chemistry. London, England: Academic Press; 2001. p. 810–1.Google Scholar

Copyright information

© ISS 2012

Authors and Affiliations

  • Luca Maria Sconfienza
    • 1
  • Sara Viganò
    • 2
  • Chiara Martini
    • 3
  • Alberto Aliprandi
    • 1
  • Pietro Randelli
    • 4
    • 5
  • Giovanni Serafini
    • 6
  • Francesco Sardanelli
    • 1
    • 5
  1. 1.Servizio di RadiologiaIRCCS Policlinico San DonatoMilanoItaly
  2. 2.Scuola di Specializzazione in RadiodiagnosticaUniversità degli Studi di MilanoMilanoItaly
  3. 3.Scuola di Specializzazione in RadiodiagnosticaUniversità degli Studi di GenovaGenovaItaly
  4. 4.Unità Operativa di Chirurgia della SpallaIRCCS Policlinico San DonatoMilanoItaly
  5. 5.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanoItaly
  6. 6.Servizio di RadiologiaOspedale Santa CoronaSavonaItaly

Personalised recommendations