Efficacy of Ultrasound-Guided Percutaneous Needle Treatment of Calcific Tendinitis

Vignesh, K. Nithin; McDowall, Adam; Simunovic, Nicole; Bhandari, Mohit; Choudur, Hema

doi:10.2214/ajr.13.11935

Cited by 27 publications

(20 citation statements)

References 19 publications

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“…Imaging follow-up is not necessary, and it is not suggested for routine use. 35 Alternatives to steroid injections should also be explored. 36 In a recent study, injection of xylocaine alone after ultrasound-guided treatment of RCCT provided a longer pain relief period than that of a mixture of xylocaine with corticosteroid.…”

Section: Discussionmentioning

confidence: 99%

“…Additional high-quality evidence is required to determine the relative efficacy of ultrasound-guided needle lavage. 35 Future studies should aim at structural uniformity, including the use of the constant score to assess outcomes. 36 A theory based on tissue hypoxia describes a "critical zone" in the rotator cuff that becomes vulnerable to calcification, 1 cm from the insertion of the supraspinatus on the greater humeral tuberosity.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound imaging-guided percutaneous treatment of rotator cuff calcific tendinitis: success in short-term outcome

Bazzocchi

Pelotti

Serraino

et al. 2016

BJR

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Objective: Rotator cuff calcific tendinitis (RCCT) is a common cause of shoulder pain in adults and typically presents as activity-related shoulder pain. Between non-surgical and surgical treatment options, today a few minimal invasive techniques are available to remove the calcific deposit, and they represent a cornerstone in the management of this painful clinical condition. The aim of the work was a retrospective evaluation of double-needle ultrasoundguided percutaneous fragmentation and lavage (DNL), focused on understanding the factors which are of major importance in determining a quick and good response at 1 month. Methods: A series of 147 patients affected by RCCT and suitable for DNL were evaluated. A systematic review of anamnestic, clinical and imaging data was performed in 144 shoulders treated in a single-centre setting. Clinical reports and imaging examinations were revisited. The inclusion criteria were submission to DNL, therefore fitness for the percutaneous procedure, and following 1-month follow-up. There was no exclusion owing to risk of bias. The treatment was defined as successful for constant shoulder modified score (CSS) improvement of .50% at 1 month. Results: In 70% of shoulders, the treatment resulted in a quick and significant reduction of symptoms (successful). On the whole, CSS increase at 1 month was estimated at 91.5 6 69.1%. CSS variations were significantly related to age of patients (better results between 30 and 40 years old), calcification size (more relevant improvement for middle-sized calcifications, 12-17 mm), sonographic and radiographic features of calcific deposits (softer calcifications) and thickening of subacromial/subdeltoid bursa walls. In the final model of stepwise regression for CSS variation, ultrasound score pre-treatment and posttreatment, the distance between bursa and calcification before treatment and the size of post-treatment calcification area were shown to be independently correlated to success. Numeric rating scale score for pain showed similar results. Pain at admission was also related to age, calcification size, ultrasound and Gärtner score, power Doppler positivity, bursal wall thickening and biceps tenosynovitis. Conclusion: The success of the procedure with quick improvement in function and symptoms is warranted in soft and middle-sized calcifications, in young adults. Advances in knowledge: Ultrasound-guided percutaneous procedures for RCCT must be safe, effective and with prompt pain relief and function restoration. This study shows which clinical picture is more favourable to this purpose and actual prognostic factors for DNL (soft and middle-sized calcifications, in young adults, are more favourable). INTRODUCTIONRotator cuff calcific tendinitis (RCCT) is a common condition, occurring in up to 20% of painful shoulders and even present in up to 7.5% of asymptomatic shoulders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound imaging-guided percutaneous treatment of rotator cuff calcific tendinitis: success in short-term outcome

Bazzocchi

Pelotti

Serraino

et al. 2016

BJR

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“…Algunas de ellas son la presencia de reacciones vagales, hemorragia o hematoma local, infección y muy raramente síncope [4][5][6] . Del cura et al 6 pre medicó a más de la mitad de los pacientes de su estudio con un ansiolítico de rápida acción para prevenir pérdidas de conciencia y/o reacciones vagales.…”

Section: Discussionunclassified

“…Una aproximación alternativa es extraer la calcificación vía procedimientos guiados por ultrasonido. Estudios previos han mostrado resultados promisorios del lavado por ultrasonido de las calcificaciones como opción terapéutica, con múltiples técnicas descritas, sin embargo, ninguna de éstas han sido aplicadas en forma universal [4][5][6] . En caso de falla del manejo conservador y, como última instancia, se debe recurrir a la artroscopia.…”

Section: Introductionunclassified

Tendinitis cálcica del manguito rotador y su lavado por ultrasonido

et al. 2017

Rev. chil. radiol.

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“…Une méta-analyse récente de 11 publications concluait à la nécessité de conduire des études de haute qualité méthodologique pour établir l'efficacité réelle de la ponctionlavage écho-guidée des calcifications de l'épaule [19]. La majorité des études disponibles sont des études ouvertes utilisant des pro- cédures hétérogènes en termes de protocole (nombre et calibre des aiguilles utilisées, simple injection sous pression de sérum physiologique chauffé ou non vs fragmentation mécanique de la calcification par exemple) concluant toutes à un effet positif sur les symptômes et sur la résorption des calcifications à court, moyen et long terme, mais on connaît l'évolution spontanément favorable de cette pathologie, ce qui incite à prendre les conclusions parfois enthousiastes des auteurs avec recul [20,21].…”

Section: Apport De L'échographie Pour Le Traitement Des Calcificationunclassified

Échographie des calcifications périarticulaires

Albert

Coiffier

2015

Revue du Rhumatisme Monographies

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Efficacy of Ultrasound-Guided Percutaneous Needle Treatment of Calcific Tendinitis

Abstract: Additional high-quality evidence is required to determine the relative efficacy of ultrasound-guided needle lavage in the management of calcific tendinitis of the rotator cuff.

Cited by 27 publications

References 19 publications

Ultrasound imaging-guided percutaneous treatment of rotator cuff calcific tendinitis: success in short-term outcome

Ultrasound imaging-guided percutaneous treatment of rotator cuff calcific tendinitis: success in short-term outcome

Tendinitis cálcica del manguito rotador y su lavado por ultrasonido

Échographie des calcifications périarticulaires

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