Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

Kim, Su Cheol; Lee, Sang Min; Park, Gun Tae; Jang, Min Chang; Yoo, Jae Chul

doi:10.5397/cise.2021.00101

Cited by 3 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results from this study are in contrast with the existing literature and question the use of ultrasound guided lavage as a treatment measure for calcific tendinopathy 30313233343536. Current treatment recommendations are mainly based on the results from case studies, which are more likely than randomised controlled trials to be influenced by confounding 11123035.…”

Section: Discussioncontrasting

confidence: 72%

“…The results from this study are in contrast with the existing literature and question the use of ultrasound guided lavage as a treatment measure for calcific tendinopathy. 30 31 32 33 34 35 36 Current treatment recommendations are mainly based on the results from case studies, which are more likely than randomised controlled trials to be influenced by confounding. 11 12 30 35 Results from these studies may also be biased due to small and selected study samples and large percentages, 24-45% of patients, who were excluded from analyses because of additional treatment during follow-up.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study

Moosmayer,

Ekeberg,

Hallgren

et al. 2023

BMJ

View full text Add to dashboard Cite

Objective To compare treatment effects between ultrasound guided lavage with corticosteroid injection and sham lavage with and without corticosteroid injection in patients with calcific tendinopathy of the shoulder. Design Pragmatic, three arm, parallel group, double blinded, sham controlled, randomised, superiority trial with repeated measurements over 24 months. Setting Six hospitals in Norway and Sweden. Participants 220 adults with calcific tendinopathy of the shoulder, persistent for at least three months. Interventions Ultrasound guided deposit lavage plus subacromial injection of 20 mg triamcinolone acetonide and 9 mL 1% lidocaine hydrochloride (lavage+steroid); sham lavage plus subacromial injection of 20 mg triamcinolone acetonide and 9 mL 1% lidocaine hydrochloride (sham lavage+steroid); or sham lavage plus subacromial injection of 10 mL 1% lidocaine hydrochloride (sham). All patients received a physiotherapeutic treatment regimen consisting of four home exercises. Main outcome measures The primary outcome was the result on the 48 point scale (0=worst; 48=best) of the Oxford Shoulder Score (OSS) at four month follow-up. Secondary outcomes included measurements on the short form of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and of pain intensity up to 24 months. The influence of the size of the deposit at baseline and of the persistence or disappearance of the deposit was investigated. Results Data from 218 (99%) participants were included in the primary analysis. Differences between groups on the OSS at four months were not significant: lavage+steroid versus sham 0.2 (95% confidence interval −2.3 to 2.8; P=1.0); sham lavage+steroid versus sham 2.0 (−0.5 to 4.6; P=0.35); lavage+steroid versus sham lavage+steroid −1.8 (−4.3 to 0.7; P=0.47). After four months, 143 patients with insufficient treatment effect received supplementary treatment. At 24 months, none of the study procedures was superior to sham. No serious adverse events were reported. Conclusions This study found no benefit for ultrasound guided lavage with a corticosteroid injection or for sham lavage with a corticosteroid injection compared with sham treatment in patients with calcific rotator cuff tendinopathy of the shoulder. Trial registration NCT02419040EudraCT 2015-002343-34; Ethical committee Norway 2015-002343-34; Ethical committee Sweden 2015/79-31; Clinicaltrials.gov NCT02419040 .

show abstract

Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study

Moosmayer,

Ekeberg,

Hallgren

et al. 2023

BMJ

View full text Add to dashboard Cite

show abstract

Nonoperative treatment of shoulder pain

Kim¹,

Chung²

2022

J Korean Med Assoc

View full text Add to dashboard Cite

Background: The shoulder joint has a wide range of motion and is extensively used. Damage in its components may cause functional deficits and pain. In particular, shoulder joint pain is associated with discomfort due to the involvement of the joint’s movement in basic tasks of daily life, such as washing one’s hair, dressing, and eating.Current Concepts: Diseases that cause shoulder joint pain include shoulder impingement syndrome, rotator cuff tear and tendinopathy, lesion of superior labrum anterior to posterior, biceps tendinitis, adhesive capsulitis, calcific tendinitis, and shoulder instability. Nonoperative treatment of shoulder joint pain includes: (1) reducing pain and preventing structural damage through rest, lifestyle modification, and physical therapy; (2) reducing pain through drug and injection treatment; (3) strengthening the rotator cuff muscles, around the scapula; and (4) performing scapular stabilization treatment through muscle strengthening. These treatments maintain the biomechanics of the shoulder joint, prevent disease progression, and enable pain-free daily life and exercise through symptom relief.Discussion and Conclusion: It is necessary to have an accurate understanding of the structures that cause shoulder joint pain. Understanding the cause of the pain can prevent the disease from progressing. Nonoperative management for shoulder pain consists of preventing a decrease in the range of motion of the shoulder joint with reduction of pain relief, preventing inflammation through drug treatment, injection treatment, lifestyle modifications, and improving muscle strength of the muscles around the rotator cuff and periscapular muscle joint through rehabilitation exercise. Nonoperative treatment modalities are valuable and cost-effective management options for shoulder pain.

show abstract

The efficacy of repeated needling for calcific tendinitis of the rotator cuff

Song

2021

Clin Shoulder Elbow

View full text Add to dashboard Cite

Treatment calcific tendinitis of the shoulder remains controversial, with continued debate on whether ultrasound-guided needling and/or lavage, subacromial corticosteroid injection, radial or focused extracorporeal shockwave therapy (ESWT) [1], or arthroscopic removal [2,3] provides optimal outcomes. A prospective randomized trial in 25 patients compared the effectiveness of ultrasound-guided needling and radial shockwave therapy [4]. Ultrasound needling resulted in less pain and faster resorption of calcifications after 6 weeks. However, no significant differences were found after 1 year. A systematic review compared ESWT, ultrasound-guided percutaneous lavage, subacromial corticosteroid injection, and combined treatments for of calcific tendinitis of the shoulder [5]. This meta-analysis suggested that combined ultrasound-guided needling and subacromial corticosteroid injection significantly decreased shoulder pain visual analog scale, improved Constant-Murley score and decreased the size of calcium deposits. Another systematic review concluded that high-energy focused ESWT was the best therapy in terms of functional recovery [6].There is little evidence regarding the prognostic factors of each modality. Chou et al. [1] reported that a poor prognosis of ESWT for calcific tendinitis was significantly related to Gartner type I calcification, calcification extent > 15 mm and a duration of

show abstract

Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

Cited by 3 publications

References 26 publications

Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study

Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study

Nonoperative treatment of shoulder pain

The efficacy of repeated needling for calcific tendinitis of the rotator cuff

Contact Info

Product

Resources

About