US-guided percutaneous treatment and physical therapy in rotator cuff calcific tendinopathy of the shoulder: outcome at 3 and 12 months
- 737 Downloads
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.
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.
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.
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.
• 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
KeywordsCalcific tendinitis of the shoulder US-guided percutaneous treatment Shoulder impingement Subacromial bursal thickening Rehabilitation
subacromial subdeltoid bursa
Constant Shoulder Score
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.
(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)
- 11.Bianchi S, Martinoli C (2007) Shoulder. In: Bianchi S, Martinoli C (eds) Ultrasound of the musculo-skeletal system. Springer- Verlag, Berlin, pp 190–331Google Scholar
- 14.Ottenheijm RP, Joore MA, Walenkamp GH, Weijers RE, Winkens B, Cals JW et al (2011) The Maastricht Ultrasound Shoulder pain trial (MUST): ultrasound imaging as a diagnostic triage tool to improve management of patients with non-chronic shoulder pain in primary care. BMC Musculoskelet Disord 8(12):154CrossRefGoogle Scholar
- 18.Panel P (2001) Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for shoulder pain. Phys Ther 81(10):1719–1730Google Scholar
- 21.Green S, Buchbinder R, Glazier RH, Forbes A (1999) Interventions for Shoulder Pain (Cochrane Review). Oxford, England: The Cochrane Library, The Cochrane Collaboration. 1.Google Scholar
- 22.Cleroux J, Feldman RD, Petrella RD (1999) Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian hypertension society, Canadian coalition for high blood pressure prevention and control, laboratory centre for disease control at health Canada, heart and stroke foundation of Canada. CMAJ 160(9 Suppl):S21–S28PubMedPubMedCentralGoogle Scholar
- 23.Barr JO (1999) Transcutaneous electrical nerve stimulation for pain management. In: Nelson RM, Hayes KW, Currier DP (eds) Clinical electrotherapy, 3rd edn. Conn: Appleton & Lange, East Norwalk, pp 291–354Google Scholar