Effectiveness of non-surgical interventions for rotator cuff calcific tendinopathy: A systematic review

Simpson, Mitchell; Pizzari, Tania; Cook, Tim; Wildman, Stuart; Lewis, Jeremy

doi:10.2340/16501977-2725

Cited by 12 publications

(28 citation statements)

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“…Calcific tendinitis is usually a self-limiting condition and, in most cases, can be treated with oral pain medications. If the pain is not well controlled with oral medications, extracorporeal shock wave therapy, subacromial steroid injection, ultrasound-guided percutaneous lavage, and iontophoresis can be applied 10 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Differential Diagnosis of Sudden-Onset Shoulder Pain in a 58-Yr-Old Male Patient With an Elevated C-Reactive Protein

Choi

Park

Lee

et al. 2021

Am J Phys Med Rehabil

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Section: Discussionmentioning

confidence: 99%

“…If the pain is not well controlled with oral medications, extracorporeal shock wave therapy, subacromial steroid injection, ultrasound-guided percutaneous lavage, and iontophoresis can be applied. 10…”

Section: Discussionmentioning

confidence: 99%

Differential Diagnosis of Sudden-Onset Shoulder Pain in a 58-Yr-Old Male Patient With an Elevated C-Reactive Protein

Choi

Park

Lee

et al. 2021

Am J Phys Med Rehabil

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“…Although most efficacious treatment for frozen shoulder remains debatable (38), an intra-articular corticosteroid injection during pain predominant phase can be administered and followed by physical therapy in the stiff predominant phase. Lastly, the calcifying tendinopathy group seems the most challenging group as the most efficacious treatment remains unclear (39). However, as calcifying tendinopathy in this group often co-occurs with bursitis, a first step might be a subacromial corticosteroid injection.…”

Section: Discussionmentioning

confidence: 99%

Phenotyping the shoulder patient based on ultrasound-detected pathologies: a cross-sectional study in general practice

et al. 2020

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Background Shoulder complaints arise from a single pathology or a combination of different underlying pathologies that are hard to differentiate in general practice. Subgroups of pathologies have been identified on the basis of ultrasound imaging that might affect treatment outcomes. Objective Our aim was to validate the existence of different subgroups of patients with shoulder complaints, based on ultrasound-detected pathology, and compare clinical features among them. Profiling shoulder patients into distinct shoulder pathology phenotypes could help designing tailored treatment trials. Methods This was a cross-sectional study in general practice. Data were extracted from 840 first visit patient records at a single diagnostic centre in the Netherlands. Exclusion criteria were age <18 years and previous shoulder surgery. Latent class analysis was used to uncover cross-combinations of ultrasound detected pathologies, yielding subgroups of shoulder patients. The uncovered subgroups were compared for demographic and clinical characteristics. Results We uncovered four distinct subgroups of patients with shoulder complaints: (i) Frozen shoulder group (11%), (ii) Limited pathology group (44%), (iii) Degenerative pathology group (31%) and (iv) Calcifying tendinopathy group (15%). Group comparisons showed significant differences in demographic and clinical characteristics among subgroups, consistent with the literature. Conclusion In a general practice population, we uncovered four different phenotypes of shoulder patients on the basis of ultrasound detected pathology. These phenotypes can be used designing tailored treatment trials in patients with shoulder complaints.

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“…The management of RCCT is mainly conservative. Simpson et al 12 reported substantial heterogeneity, compounded by poor methodological quality, in the studies investigating the effectiveness of non-surgical interventions for RCCT. Therefore, no strong evidence in favour of any non-surgical intervention was identified 12.…”

Section: Introductionmentioning

confidence: 99%

“…Simpson et al 12 reported substantial heterogeneity, compounded by poor methodological quality, in the studies investigating the effectiveness of non-surgical interventions for RCCT. Therefore, no strong evidence in favour of any non-surgical intervention was identified 12. High-energy extracorporeal shockwave therapy (ESWT) appears to be a more effective non-surgical intervention when compared with placebo for improving shoulder function in the first 6 months after completing the intervention.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of non-surgical management in rotator cuff calcific tendinopathy (the effect trial): protocol for a randomised clinical trial

Caballero,

Dueñas,

Balasch-Bernat

et al. 2024

BMJ Open

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IntroductionRotator cuff calcific tendinopathy (RCCT) involves calcific deposits in the rotator cuff. Non-surgical interventions such as extracorporeal shockwave therapy (ESWT) and ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) are recommended for its early management. Exercise therapy (ET) has shown to be an effective intervention for people with rotator cuff tendinopathy, but it has not been formally tested in RCCT. The main objective of this study is to compare the effectiveness of an ET programme with ESWT and US-PICT in people with RCCT. As a secondary aim, this study aims to describe the natural history of RCCT.Methods and analysisA randomised, single-blinded four-group clinical trial will be conducted. Adults from 30 to 75 years diagnosed with RCCT who accomplish eligibility criteria will be recruited. Participants (n=116) will be randomised into four groups: ET group will receive a 12-week rehabilitation programme; ESWT group will receive four sessions with 1 week rest between sessions during 1 month; US-PICT group will receive two sessions with 3 months of rest between sessions; and (actual) wait-and-see group will not receive any intervention during the 12-month follow-up. The primary outcome will be shoulder pain assessed with the Shoulder Pain and Disability Index at baseline, 2 weeks, 4 months, 6 months and 12 months from baseline. The primary analysis will be performed at 12 months from baseline. Secondary outcomes will include pain, range of motion, patient satisfaction and imaging-related variables. Moreover, the following psychosocial questionnaires with their corresponding outcome measure will be assessed: Central Sensitization Inventory (symptoms related to central sensitization); Pain Catastrophizing Scale (pain catastrophizing); Tampa Scale for Kinesiophobia 11 items (fear of movement); Fear Avoidance Belief Questionnaire (fear avoidance behaviour); Hospital Anxiety and Depression Scale (anxiety and depression); Pittsburgh Sleep Quality Index (sleep quality); and the EuroQol-5D (quality of life). An intention-to-treat analysis will be performed to reduce the risk of bias using a worst-case and best-case scenario analysis.Ethics and disseminationEthics committee approval for this study has been obtained (reference number: 1718862). The results of the main trial will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT05478902.

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Effectiveness of non-surgical interventions for rotator cuff calcific tendinopathy: A systematic review

Cited by 12 publications

References 0 publications

Differential Diagnosis of Sudden-Onset Shoulder Pain in a 58-Yr-Old Male Patient With an Elevated C-Reactive Protein

Differential Diagnosis of Sudden-Onset Shoulder Pain in a 58-Yr-Old Male Patient With an Elevated C-Reactive Protein

Phenotyping the shoulder patient based on ultrasound-detected pathologies: a cross-sectional study in general practice

Effectiveness of non-surgical management in rotator cuff calcific tendinopathy (the effect trial): protocol for a randomised clinical trial

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