Clinical/Sonographic Assessment and Management of Calcific Tendinopathy of the Shoulder: A Narrative Review

Ricci, Vincenzo; Mezian, Kamál; Chang, Ke‐Vin; Özçakar, Levent

doi:10.3390/diagnostics12123097

Cited by 7 publications

(7 citation statements)

References 48 publications

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“…Hibberd et al 11 found that AHD was not different between swimmers and nonoverhead athletes in preseason measurements; however, another study showed that AHD significantly decreased in swimmers during the training season for 12 weeks 12 . Our study revealed that AHD did not significantly decrease throughout the competitive season, because of the land‐based training program that includes strengthening of the muscles that prevent excessive cranial translation of the humeral head 32,33 . Another possible reason could be the preadolescent age of our population with naturally shorter exposure to swimming training.…”

Section: Discussionmentioning

confidence: 52%

“…12 Our study revealed that AHD did not significantly decrease throughout the competitive season, because of the land-based training program that includes strengthening of the muscles that prevent excessive cranial translation of the humeral head. 32,33 Another possible reason could be the preadolescent age of our population with naturally shorter exposure to swimming training. Nonetheless, slight narrowing of the AHD could have also stemmed from scapular motion disorders, that is, the lack of sufficient increase in back muscles strength (responsible for scapular stabilization).…”

Section: Discussionmentioning

confidence: 99%

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Shoulder structures and strength in competitive preadolescent swimmers: A longitudinal ultrasonographic study

Özçadırcı

Doğan

Öztürk

et al. 2023

PM&R

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BackgroundRepetitive shoulder movements during competitive training may cause changes in the strength of periarticular shoulder structures in preadolescent swimmers.ObjectiveTo prospectively determine the effects of training on shoulder periarticular structures and muscle strength in preadolescent swimmers.DesignProspective cohort study.SettingCommunity‐based natatorium.ParticipantsTwenty‐four preadolescent swimmers aged 10–12 years.InterventionsNot applicable.Main Outcome MeasuresMeasurements were repeated in three periods as preseason, midseason, and postseason. Ultrasonographic measurements (supraspinatus tendon thickness, humeral head cartilage thickness, deltoid muscle thickness, and acromiohumeral distance) were performed using a portable device and a linear probe. Shoulder (flexion, extension, abduction, internal and external rotation) and back (serratus anterior, lower, and middle trapezius) isometric muscle strength were measured with a handheld dynamometer.ResultsSupraspinatus tendon thickness and acromiohumeral distance were similar in all periods (all p > .05); however, deltoid muscle and humeral head cartilage thicknesses increased throughout the season (p = .002, p = .008, respectively). Likewise, whereas shoulder muscle strength increased (all p < .05), back muscle strength was similar in all periods (all p > .05).ConclusionsIn preadolescent swimmers, acromiohumeral distance and supraspinatus tendon thickness seem to not change; but humeral head cartilage and deltoid muscle thicknesses as well as shoulder muscle strength increase throughout the season.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Shoulder structures and strength in competitive preadolescent swimmers: A longitudinal ultrasonographic study

Özçadırcı

Doğan

Öztürk

et al. 2023

PM&R

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“…Usually, de-coaptation exercises (e.g., Codman’s pendulum) and strengthening for the humeral head depressor muscles are performed during athletic training by professional padel players to rebalance the force vectors involved in the vertical shoulder movements [ 9 ].…”

Section: Upper Limbmentioning

confidence: 99%

Musculoskeletal disorders in padel: from biomechanics to sonography

Cocco,

Ricci,

Corvino

et al. 2024

J Ultrasound

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Padel is a racket sport, combining high-frequency and low-intensity athletic gestures, that has been gaining growing scientific interest in recent years. Musculoskeletal injuries are very common among padel players with an incidence rate of 3 per 1000 h of training and 8 per 1000 matches. To the best of our knowledge, a comprehensive collection describing the most common sonographic findings in padel players with musculoskeletal injuries is lacking in the pertinent literature. In this sense, starting from the biomechanical features of padel-specific gestures we have reported the ultrasonographic patterns of most frequent injuries involving the upper limb, the trunk, and the lower limb. Indeed, comprehensive knowledge of the biomechanical and clinical features of musculoskeletal injuries in padel is paramount to accurately perform a detailed ultrasound examination of the affected anatomical site. So, the present investigation aims to provide a practical guide, simple and ready-to-use in daily practice, to optimize the sonographic assessment of padel players by combining it with the clinical findings and the biomechanical features of athletic gestures.

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“…Shoulder strength was tested in internal rotation, external rotation, empty can position (supraspinatus), lift-off test, and adduction. Strength was measured utilizing handheld dynamometers, which were shown to be an objective method to measure shoulder strength, with high inter-rater and intra-rater reliability [26][27][28]. Measurements were obtained for all of the maximal loads in Newtons when the patients were instructed to build a maximum voluntary contraction for 1-2 s prior to the application by resistance of the examiner to the action.…”

Section: Range Of Motion and Strength Assessmentmentioning

confidence: 99%

Ultrasound Guided Arthroscopic Removal of Calcific Tendonitis: A Minimum of 2-Year Followup

Rizvi

Qiu

Lam

et al. 2023

JCM

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Background: We have developed a novel technique for managing rotator cuff calcific tendonitis, involving arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance. While we have demonstrated encouraging results at six-month follow-up, the medium-term outcomes and the long-term outcomes of this technique at 2 years or beyond are unknown. The aim of this paper was to determine if this technique was successful in resolving symptoms after two years and beyond. Study Design: Retrospective Cohort Study. Methods: Patients who underwent arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance by a senior surgeon were evaluated using patient-rated pain scores and functional status with the use of the Likert scales and via examiner-rated shoulder range-of-motion and strength at the pre-operative visit, at 1, 6, 12, and 24 weeks post-operatively, and long-term at a mean of 249 weeks after surgery. Results: At a mean follow-up period of 4.8 years (range, 2–10 years), 31 patients (33 shoulders) experienced significant improvement in the severity of pain at rest, with overhead activities, and during sleep compared to their pre-operative presentation (p < 0.001). The patient experienced less frequent pain during activities and sleep, and a decreased frequency of extreme pain (p < 0.001). Passive range of abduction (p = 0.003), forward flexion (p < 0.001), and supraspinatus strength (p = 0.018) improved compared to the presurgical presentation. Out of 27 patients, 24 patients (89%) had complete resolution of calcific tendonitis, and 26 patients (96%) had an intact rotator cuff. Conclusion: Arthroscopic debridement of calcific tendonitis with localization assistance from a breast biopsy needle under ultrasound guidance was very effective. Patients had significant pain relief, improved range of motion, and a reduction in stiffness at a mean post-operative period of 4.8 years. Patients had a significant reduction in residual calcification, and rotator cuff integrity was largely preserved by long-term follow-up. What is known about this subject: Calcific tendonitis of the rotator cuff is one of the most painful and debilitating disorders of the shoulder. This condition is characterized by the deposition of calcium-phosphate crystals within the rotator cuff tendons. Arthroscopic debridement and excision of rotator cuff calcifications have proven to be efficacious treatments with regards to clinical and functional outcomes in the short and medium term. Identifying the calcific lesion intra-operatively, however, can prove to be challenging. Furthermore, inadequate excision of the calcific deposit has been shown to have poorer clinical outcomes. We designed a technique that utilizes the assistance of ultrasound to guide a localization-biopsy wire to the calcific lesion. This technique aids in precisely identifying the location of the lesion intra-operatively to optimize accuracy in removing the maximum amount of calcific deposit possible. A short-term follow-up study by us has demonstrated successful outcomes with regards to the return of function and relief of pain. However, there have been no studies evaluating the effectiveness of this particular technique beyond six months. What this study adds to current knowledge: At a mean of 4.8 years, arthroscopic debridement of calcific tendonitis, using our technique, was successful in relieving the severity and frequency of pain with overhead activities, pain at rest, and pain during sleep, as well as improving range of motion.

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Clinical/Sonographic Assessment and Management of Calcific Tendinopathy of the Shoulder: A Narrative Review

Cited by 7 publications

References 48 publications

Shoulder structures and strength in competitive preadolescent swimmers: A longitudinal ultrasonographic study

Shoulder structures and strength in competitive preadolescent swimmers: A longitudinal ultrasonographic study

Musculoskeletal disorders in padel: from biomechanics to sonography

Ultrasound Guided Arthroscopic Removal of Calcific Tendonitis: A Minimum of 2-Year Followup

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