Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness of Physical Therapy

Fernández-Cuadros, Marcos Edgar; Pérez-Moro, Olga Susana

doi:10.4172/2329-6879.1000220

Cited by 9 publications

(55 citation statements)

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“…CT is a common, painful, crippling disease, with great socio economic impact (18), high demand and great use of resources (19) and labor absenteeism (8). Pain is the leading cause of disability due to loss of mobility.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, 11.36% of patients (n = 5) had limited mobility. Some authors argue that this pain remains in 50% of cases up to a year after the first consultation (19), while others claim that CT can evolve spontaneously toward healing between three and ten years (11); this fact negatively affects patients' quality of life in their personal, familial and work aspects (8).…”

Section: Discussionmentioning

confidence: 99%

“…The clinical picture is highly variable. There are asymptomatic patients (incidental radiological finding), patients with chronic pain and patients in acute painful crisis, mainly associated with the resorptive phase (8) nosis is clinical and radiological (1,8,9). CT treatment is initially conservative and depends on its evolutionary stage (10).…”

Section: Introductionmentioning

confidence: 99%

“…Conservative treatment includes Non-Steroidal AntiInflammatory Drugs (NSAIDs), physiotherapy, electrotherapy (micro waves, short waves, transcutaneous electrical nerve stimulation (TENS), ultrasounds, iontophoresis, interferential and pulsed electromagnetic therapy) (8). It is demonstrated recently that different electrotherapy techniques are useful to reduce pain but not the calcification on CT patients (8).…”

Section: Introductionmentioning

confidence: 99%

“…It is demonstrated recently that different electrotherapy techniques are useful to reduce pain but not the calcification on CT patients (8).…”

Section: Introductionmentioning

confidence: 99%

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Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness of Acetic Acid Iontophoresis and Ultrasound

Fernández-Cuadros¹,

Moro

Rabasa

et al. 2016

Middle East J Rehabil Health

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Objectives: To clinically characterize calcifying tendonitis of the shoulder (CT) through a prospective quasi-experimental beforeand-after study, which provides a level of demonstrable evidence to support the decision-making and demonstrate the effectiveness of acetic acid iontophoresis and ultrasound in the treatment of CT. Methods: Prospective, quasi-experimental before-after intervention study was conducted on 44 patients who referred to the rehabilitation department, Santísima Trinidad's General Foundation hospital, Salamanca, from June 2014 to April 2016. Outcome measures: 1) Pain: measured by visual analogical scale (VAS); 2) calcification size: in millimetres, both measured radiologically at the beginning/end of treatment; 3) Intervention: Iontophoresis with 5% acetic acid at 4.7 mA × 10 minutes and continuous ultrasound 1 W/cm 2 /1 MHz × 5 minutes over calcification.Results: Mean age of the subjects was 54.2 years (n = 44), 65.9% female (n = 29), (95% with supraspinatus tendon (n = 38) and 5% with subscapularis (n = 2); 55% had complication in left shoulder (n = 22), 45% in right shoulder (n = 18) and 4.5% bilateral (n = 2). Regarding the occupation, 59.1% had (n = 26) administrative positions and 40.9% manual jobs (n = 18). On personal history: 34.09% were smoker (n = 15), 4.5% had diabetes (n = 2) and calcium intake secondary to osteoporosis was recorded for 2.27% (n = 1) of the subjects. Regarding radiological type: 68.18% formative (n = 30), 38.72% resorptive (n = 14) were observed. Average number of sessions was 19 and 9.01% (n = 4) of the subjects had treatment complications as intolerance/erythema/burn. Average initial pain was 7.7 points (VAS scale), significantly decreased (P = 0.0000) post treatment to 2.2. Initial average size of calcification was 10 mm and significantly decreased (P = 0.0000) post treatment to 3 mm. With respect to the change of calcification: success/cure rate was 56.8% (n = 25), improvement rate was 25% (n = 11); failure rate was 18.2% (n = 8). Conclusions: CT is common in middle-aged working females. It affects supraspinatus tendon. It is associated with smoking. Occupational risk factors are awkward positions and lifting weights. Iontophoresis with 5% acetic acid and ultrasound is a safe, simple and inexpensive technique, capable to reduce pain and calcification, with a recommended degree of scientific evidence (2B).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It is demonstrated recently that different electrotherapy techniques are useful to reduce pain but not the calcification on CT patients (8).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness of Acetic Acid Iontophoresis and Ultrasound

Fernández-Cuadros¹,

Moro

Rabasa

et al. 2016

Middle East J Rehabil Health

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Global Hypertrophic Calcification of Shoulder Joint Capsule

Aldehaim

Al-Arfaj

2021

Clin Med Insights Case Rep

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Background: Calcification around the shoulder joint usually occur inside or around the tendons of the rotator cuff. We herein report on a case of global hypertrophic calcification of shoulder joint capsule in a patient with Rheumatoid arthritis. Case Report: An 86 years-old male with a long-standing history of seropositive Rheumatoid arthritis. The treatment for his Rheumatoid arthritis included Methotrexate and Hydroxychloroquine initially, but due lack of control, adalimumab was added with excellent control of his arthritis. He has progressively experienced an increasing pain and stiffness in his shoulders, in addition to an increasing limitation of shoulder movement. Magnetic Resonance Imaging revealed severe arthritis with remoulding deformity with extensive capsular calcification, intra-articular loose-bodies. Discussion: This phenomenon of calcification of shoulder capsule has not been reported before. The pathophysiology of calcific tendinopathy of the shoulder remains controversial. The calcific deposits consist of poorly-crystallized hydroxyapatite. Conclusion: Global hypertrophic calcification of shoulder joint capsule is unique and unreported in the literature. We can postulate that the long-standing inflammation of the synovial lining of the capsules had a major part. Moreover, Diabetes Mellitus, smoking, and repetitive manoeuvres are recognized contributing factors as well for similar conditions. Genetic predisposition seems to play a role as well. We think all those have played part in the development of this unprecedented presentation. Management should be tailored to target specific symptoms for pain, rigidity, and decreasing calcification size. Several options are available, including Kinesiotherapy, electrotherapy modalities, iontophoresis, electroshock wave therapy, and finally surgical approaches for progressive and refractory cases.

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2021

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Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness of Physical Therapy

Cited by 9 publications

References 0 publications

Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness of Acetic Acid Iontophoresis and Ultrasound

Calcifying Tendonitis of the Shoulder: Risk Factors and Effectiveness of Acetic Acid Iontophoresis and Ultrasound

Global Hypertrophic Calcification of Shoulder Joint Capsule

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