Document Detail


Prognostic factors in nonoperative therapy for chronic symptomatic calcific tendinitis of the shoulder.
MedLine Citation:
PMID:  19790063     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To define prognostic factors in chronically symptomatic patients with calcific tendinitis of the shoulder. METHODS: We evaluated 420 patients (488 shoulders) in the context of a prospective cohort study. Epidemiologic data were assessed. The radiographic and sonographic appearance of the calcific deposits was classified. The mean period of nonoperative therapy was 4.4 years (range 0.5-13.7 years). After referral to our institution, standardized nonoperative therapy was continued for a minimum of 3 months. Failure of nonoperative therapy was defined as the persistence of symptomatic calcific tendinitis of the shoulder after a minimum of 6 months. Prognostic factors (determined at P < 0.05 by chi-square test) were analyzed by logistic regression. RESULTS: Of the 420 patients, 269 (64%) were women, 151 (36%) were men. The mean age of the patients was 51.3 years (range 28-84 years). Occurrence of calcific tendinitis of the shoulder was unilateral in 84% and bilateral in 16%. Gärtner type I calcific deposits were found in 37%, type II in 32%, and type III in 31%. Failure of nonoperative therapy was observed in 114 patients (27%). Negative prognostic factors were bilateral occurrence of calcific tendinitis of the shoulder, localization to the anterior portion of the acromion, medial (subacromial) extension, and high volume of the calcific deposit. Positive prognostic factors were a Gärtner type III deposit and a lack of sonographic sound extinction of the calcific deposit. CONCLUSION: Our findings demonstrate the existence of prognostic factors in the nonoperative treatment of chronic symptomatic calcific tendinitis of the shoulder. Guidelines for optimal treatment can be implemented according to these factors to avoid a long-term symptomatic disease course.
Authors:
P Ogon; N P Suedkamp; M Jaeger; K Izadpanah; W Koestler; D Maier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  60     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-14     Completed Date:  2009-11-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2978-84     Citation Subset:  AIM; IM    
Affiliation:
Center of Orthopedic Sports Medicine Freiburg, Freiburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Calcinosis / diagnosis*,  physiopathology,  therapy*
Cohort Studies
Electric Stimulation Therapy
Female
Follow-Up Studies
Guidelines as Topic
Humans
Logistic Models
Male
Middle Aged
Physical Therapy Modalities
Prognosis
Prospective Studies
Shoulder Joint / physiopathology*,  radiography,  ultrasonography
Tendinopathy / diagnosis*,  physiopathology,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal

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