Summary
In an open study the therapeutic value of percutaneous needle aspiration and lavage performed in local anaesthesia under image intensifier control in patients with chronic calcifying shoulder tendinitis was investigated. 60 patients (62 shoulders) were included in the study. The average age was 48 years, and the median duration of shoulder pain and calcification was 24 months and 7 months respectively. The right shoulder was affected in 34 and the left in 24 patients; two patients had painful calcifications in both shoulders. In 47% X-ray showed calcium deposits in the contralateral shoulder. 77% of the painful deposits projected on the supraspinatus tendon and in most cases image intensifier examination showed multiple calcifications. Calcareous material could be removed by needle aspiration and lavage in 76% of all cases. There was no correlation regarding the preferred working hand and the side of calcifying tendinitis. X-ray controls performed after 2 months revealed a significant reduction of the size of calcifications. The clinical follow-up 2 and 6 months after needling showed a significant reduction of global pain intensity. There were also significant improvements in the areas of pain on movement, pain at night and impairment of sleep. Clinical success was independent of the radiological aspect of the calcifications.
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References
Hedtmann A., Fett H. Die sogenannte Periarthropathia humeroscapularis. Klassifizierung und Analyse anhand von 1266 Fällen. Z Orthop 1989, 127, 643–649.
Comfort T.H., Arafiles R. Barbotage of the shoulder with image-intensified fluoroscopic control of needle placement for calcific tendinitis. Clin Orthop 1978, 135, 171–178.
Patterson R.L. Treatment of acute bursitis by needle irrigation. J Bone Joint Surg 1937, 19, 993.
Harmon P.H. Methods and results in the treatment of 2580 painful shoulders. Am J Surg 1958, 95, 527–544.
De Palma A.F., Kruper J.S. Long-term study of shoulder joints afflicted with and treated for calcific tendinitis. Clin Orthop 1961, 20, 61–72.
Kuta J., Onkelinx A. Ponction-lavage des calcifications du tendon sus-épineux. Medica Physica 1989, 12, 89–90.
Moutounet J., Chevrot A., Godefroy D., Horreard P., Zenny J.C., Auberge T., et al. Ponction-infiltration radio-guidée dans le traitement des périarthrites calcifiantes rebelles d'épaules. J Radiol 1984, 65(8–9), 569–572.
Normandin C., Ortiz-Bravo E. Ponctions de calcifications de l' épaule. Le Concours Médical 1987, 109–128.
Thümler P., Pulvers E., Koob E. Indikation, Technik und Ergebnisse der sogenannten Bursaspülung bei der schmerzhaften Schulter. In: Buchreihe für Orthopädie und orthopädische Genzgebiete. Ed.: Reichelt, A., Uelzen, Medizinisch-literarische Verlagsgesellschaft, 1984, 8, 82–84.
Pfister J., Gerber H. Behandlung der Periarthropathia humeroscapularis mittels Schulterkalkspülung: retrospektive Fragebogenanalyse. Z Orthop 1994, 132(4), 300–305.
Noel E., Brantus J.F. Les calcifications de la coiffe des rotateurs. Traitement médical. In: Journées Lyonnaises de L'épaule. Eds.: Walch, H., Noel, E., Liotard, J.-P., 1993, 199–227.
Gärtner J. Tendinosis calcarea — Behandlungsergebnisse mit dem Needling. Z Orthop 1993, 131, 461–469.
Vi Gario G.D., Keats T.E. Localization of calcific deposits in the shoulder. Am J Roentgenol 1970, 108(4), 806–811.
Uhthoff H.K. Calcifying tendinitis. In: The shoulder. Eds.: Rockwood, M., Matson, F.A, Philadelphia, Saunders, 1990, 774–790.
Codman E.A. The Shoulder. Boston, Thomas Todd, 1934.
Mc Laughlin H.L. Lesions of the musculotendinous cuff of the shoulder. III. Observations on the pathology, course and treatment of calcific deposits. Ann Surg 1946, 124, 354–362.
Wessinghage D. Periarthritis humero-scapularis. Dtsch Med Wochenschr 1973, 44, 2099.
Moseley H.F. Shoulder lesions. 3rd ed., Edinburgh, Livingstone, 1969, 99–118.
Rathburn J.B., Macnab J. The microvascular pattern of the rotator cuff. J Bone Joint Surg 1970, 52B, 540–553.
Uhthoff H.K., Sarkar K., Maynard J.A. Calcifying tendinitis. Clin Orthop 1976, 118, 164–168.
Nutton R.W., Stothard J. Acute calcific supraspinatus tendinitis in a three-year-old child. J Bone Joint Surg 1987, 69B(1), 148.
Holt P.D., Keats T.E. Calcific tendinitis: a review of the usual and unusual. Skeletal Radiol 1993, 22, 1–9.
Cannon R.B., Schmid F.R. Calcific periarthritis involving multiple sites in identical twins. Arthritis Rheum 1973, 16(3), 393–396.
Neer C.S. II. Shoulder Reconstruction. Philadelphia, Saunders, 1990.
Hartig A., Huth F. Neue Aspekte zur Morphologie und Therapie der Tendinosis calcarea der Schultergelenke. Arthroskopie 1995, 8, 117–122.
Mc Kendry R.J.R., Uhthoff H.K., Sarkar K., Hyslop P.S.G. Calcifying tendinitis of the shoulder: prognostic value of clinical, histologic, and radiologic features in 57 surgically treated cases. J Rheumatol 1982, 9(1), 75–80.
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Pfister, J., Gerber, H. Chronic calcifying tendinitis of the shoulder-therapy by percutaneous needle aspiration and lavage: A prospective open study of 62 shoulders. Clin Rheumatol 16, 269–274 (1997). https://doi.org/10.1007/BF02238962
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DOI: https://doi.org/10.1007/BF02238962