Document Detail


The outcome of ultrasound-guided needle decompression and steroid injection in calcific tendinitis.
MedLine Citation:
PMID:  19959377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Needle lavage is frequently performed before consideration of surgical removal in shoulders with calcific tendinitis because this may avoid surgery. However, its role in nonoperative treatment has not been fully investigated in terms of clinical and radiographic response. We hypothesized that needle decompression and subacromial steroid injection would show good clinical results in chronic calcific tendinitis patients. MATERIALS AND METHODS: Thirty-five shoulders in 30 consecutive patients with painful calcific tendinitis were treated by ultrasound-guided needle decompression and subacromial corticosteroid injection. Patients were prospectively evaluated using American Shoulder and Elbow Surgeons (ASES) and Constant scores at 1, 3, and 6 months after the intervention. Size and morphology of the calcific deposits were compared with those in baseline radiographs at each visit. RESULTS: At 6 months after the index procedure, 25 shoulders (71.4%) showed ASES and Constant score improvements from 48.0 and 53.7 to 84.6 and 87.9, respectively (P < .01). Ten shoulders (28.6%) showed no symptom relief at the last follow-up. In shoulders with pain improvement, the mean size of calcific deposits reduced from 13.6 to 5.6 mm (P < .01), and in shoulders with no pain improvement or that underwent operation, mean size was 13.1 mm at initial visits and 12.7 mm at final visits (P = .75). DISCUSSION: Shoulders showing little evidence of deposit size reduction at 6 months after needle decompression are less likely to achieve symptomatic improvement and may be considered as candidates for surgical removal. CONCLUSION: Needle decompression with subacromial steroid injection is effective in 71.4% of calcific tendinitis within 6 months. The size of calcific deposits in patients that achieved symptom relief was reduced.
Authors:
Jae Chul Yoo; Kyoung Hwan Koh; Won Hah Park; Jae Chul Park; Sang Min Kim; Young Cheol Yoon
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-02
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  19     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  596-600     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Acromion
Adult
Aged
Anti-Inflammatory Agents / administration & dosage*
Calcinosis / physiopathology,  therapy*,  ultrasonography
Decompression, Surgical / methods*
Female
Follow-Up Studies
Humans
Injections, Intra-Articular
Male
Methylprednisolone / administration & dosage,  analogs & derivatives*
Middle Aged
Prospective Studies
Range of Motion, Articular
Shoulder Joint*
Tendinopathy / physiopathology,  therapy*,  ultrasonography
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 53-36-1/methylprednisolone acetate; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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