To describe a technique for US-guided percutaneous treatment (needle aspiration and ‘washing’) of rotator cuff calcifications and to evaluate the clinical response to this treatment.
METHOD AND MATERIALS
2543 symptomatic shoulders (1607 women, mean age 42, range 29-72) in patients with RX or US diagnosis of rotator cuff calcific tendonitis and with shoulder pain unresponsive to medical treatment were treated.
The procedure is performed with a sterile technique and involves two expert radiologists. The calcification is pricked under US guidance with a 14-16 G needle after local injection of anaesthetic. Successive pressures and aspirations are performed with the syringe plunger to ‘wash’ the tendon with saline solution and retrieve calcific material, until the aspirate is completely free from calcium. The next step is the injection of steroid in the subacromion-subdeltoid bursa. 2018/2543 patients were followed-up clinically for one year after the treatment.
In 71,7% of patients it was possible to fully aspirate the calcification with a considerable reduction of symptoms and significant improvement of the mobility of the affected limb.
In 23,6% of patients a second treatment was performed because of the presence of more than one calcification.
In 3,8% of patients the calcification had broken spontaneously before the treatment or had moved into the subacromial-subdeltoid bursa (and then successfully treated).
In 0,9% of patients no resolution of symptoms has occurred because of the coexistence of a tendon tear.
This US-guided technique for the therapy of tendon calcifications is a quick, non invasive, successful and cheap procedure in comparison with the fluoroscopic guidance. It allows to obtain significant and longlasting reduction of symptoms in shoulder calcific tendonitis.
This technique allows to obtain significant and longlasting reduction of symptoms in shoulder calcific tendonitis.