Clin Should Elbow.  2017 Jun;20(2):84-89. 10.5397/cise.2017.20.2.84.

Needling Procedures for Calcific Tendinitis Performed by Orthopedic Surgeons

• Pang CH
• Kum DH
• Jeong JY
• Park SM
• Yoo JC

• KMID: 2391085
• DOI: http://doi.org/10.5397/cise.2017.20.2.84

Abstract

BACKGROUND
Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department.
METHODS
Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and post-needling size and shape of the calcific deposits were compared between the two groups.
RESULTS
We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator.
CONCLUSIONS
Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

Keyword

Shoulder joint; Rotator cuff; Tendinopathy; Ultrasonography; Interventional; Calcific tendinitis