Based on radiographs at 1 year follow-up. 74% (45 of 61) of the calcifications decreased, including 28% (17 of 61) which disappeared totally, and 26% (16 of 61) were unchanged. Calcifications with a faint or absent shadow on US proved to be nearly liquid (slurry calcification in 93% (14 of 15) of cases and could be aspirated. Clinical results were excellent in 74% (45 of 61), moderate in 16% (10 of 61) and poor in 10% (6 of 61) of cases. US offers technical advantages over fluoroscopy, and the typical US image of a slurry calcification helps to select the most suitable patients for aspiration treatment. The results are comparable with those using fluoroscopic guidance.
Use of this US-guided technique is successful to treat calcific tendinitis in the rotator cuff without the radiation exposure of fluoroscopic guidance.
We studied the findings and value of sonography in the diagnosis of rotator cuff calcifications in comparison to plain radiographs. Sonograms were correlated with plain radiographs in 951 patients. The diagnosis of rotator cuff calcifications was made by ultrasonogra}'hy in 87 and with plain films in 93 of 951 patients. Sonography displayed two additional bursal slurry calcifications not found on plain films. Three types of calcifications were found with ultrasonography: (1) a hyperechoic focus with a welldefined shadow (79%); (2) a hyperechoic focus with a faint shadow {14%); and, (3) a hyperechoic focus C aldfic tendinitis is a common painful condition of the shoulder due to deposition of hydroxyapatite crystals) The deposition is predominantly in the tendons of the rotator cuff, most often at the insertion of the supraspinatus tendon on the tuberosity,2-4 rarely in the other three tendons of the rotator cuff, and sometimes within the tendon or sheath of the long head of the biceps ABBREVIATIONS cr, Computed tomography; MR, Magnetic resonance
Reconstruction of the damaged articular surface of the patellar articulation with free periosteal grafts was performed in 13 patients who had not responded to previous treatment. After an average of 4 years, a good result was obtained in 8 patients and a fair result in 4 others. Only 1 patient, a 55-year-old man with severe patellar arthrosis, continued to have disabling pain.
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