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KMID : 1195520120050010001
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Journal of Korean Orthopaedic Ultrasound Society
2012 Volume.5 No. 1 p.1 ~ p.8
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The Preliminarily Result of Radiologic Disappearance of the Calcific Material on One Time Ultrasonographic Assisted Needling
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Yoo Jae-Chul
Shon Min-Soo
Koh Kyoung-Hwan
Lim Tae-Kang
Lee Yeong-Seok
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Abstract
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Purpose: The purpose of this study is to report the preliminarily result of the radiologic disappearance of the calcific material, regardless of the size, type or location, on one-time ultrasonographic (US) assisted needling for calcific tendinitis of the shoulder.
Materials and Methods: From March to August 2011, 46 patients (47 shoulders) with symptomatic calcific tendinitis were treated by one-time US assisted needling. Initially, a diagnostic US was performed with patient to determine the locations, numbers and sizes of calcific deposits. After 1% lidocaine local anesthesia, the calcific material was punctured with an 18-gauge needle under US monitoring. If no calcific material was aspirated after 2 or 3 additional attempts, the deposits was performed multiple puncture to achieve decompression. And then all patients were performed subacromial corticosteroid injection. All patients were followed up 4 weeks after procedure. To assess the radiologic disappearance after one-time US assisted needling, simple radiographs of the treated shoulder were performed and size, dense, and morphology of the calcific deposits were compared with those in baseline radiographs.
For clinical evaluations, visual analogue scale for pain and function (PVAS and FVAS), and American Shoulder and Elbow Surgeons (ASES) score were assessed.
Results: There were 11 male and 35 female patients with the mean age of 53.8 years (28-71). The morphology of the calcific deposits were 31 type A and 16 type B by French Arthroscopic Society classification and mean size was 12.9±6.7 mm before the procedure. At 4 weeks after the index procedure, the radiographic unchanged group was included
in 10 cases and changed group was 37 cases. No intergroup difference for the clinical results after the procedure
was evident, but group FAS classification before the procedure was significantly different (p=0.011).
Conclusion: At 4 weeks after one-time US assisted needling for calcific tendinitis of the shoulder, the radiographic size- or dense- changed cases were showed in 79%, regardless of the size, type or location of the calcific material.
But the radiographic nearly or complete disappearance were showed in only 21%.
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KEYWORD
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Shoulder, Calcific tendinitis, Ultrasonographic assisted needling
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