Treatment of Calcific Tendinitis by Ultrasound-guided Needle Lavage

Treatment of Calcific Tendinitis by Ultrasound-guided Needle Lavage

Study population: Subjects with long standing symptoms from calcific tendonitis, non-responsive to other forms of conservative treatment

Study method: A cohort of 50 patients with symptomatic calcific tendonitis will be treated by ultrasound-guided needle lavage. At baseline all study subjects will be assessed by clinical examination, imaging of the shoulder by x-ray and sonography and by the self-report section of the American Shoulder and Elbow Surgeons score (ASES). Follow-up will be performed after 1 and 4 weeks (score only), 3 (clinical, score, ultrasound, x-ray), 6 and 12 months (score only), and after 24 months (clinical, score, ultrasound, x-ray). Patients with insufficient treatment effect will be offered physiotherapy, re-lavage or surgical treatment by acromioplasty.

Purpose of the study: The investigators want to find out

• if shoulder function, measured by a shoulder score, will increase during follow-up
• how much of the calcific material can be aspirated (in ml)
• to which extend the calcific deposit disappears on x-rays and sonographic images
• how many patients will need surgical treatment

Inclusion Criteria:

• Shoulder pain for at least 6 months, localised laterally on the upper humerus
• Painful arc
• Positive Hawkins test and/or Neers tegn for impingement
• Calcific deposit of >= 5 mm on shoulder x-ray, verified on sonography with a localisation in the supraspinatus or infraspinatus tendon

Exclusion Criteria:

• The presence of other local or systemic diseases affecting shoulder function like arthritis, inflammatory arthropathy or instability
• Symptoms from a cervical root syndrome
• Sonographic or MRI findings for a rotator cuff tear
• Earlier surgery in the study shoulder