Comparison of the Efficiency of Ultrasound-Guided Lavage and Subacromial Bursa Injection in Calcific Tendinitis

Comparison of the Efficacy of Ultrasound-Guided Lavage and Subacromial Bursa Injection in Calcific Tendinitis: A Prospective, Randomized, Double-Blind Study

It is aimed to compare in the early period the clinical and ultrasonographic findings in terms of the effectiveness of ultrasound-guided subacromial bursa injection with corticosteroid and ultrasound-guided lavage, which are the treatment options available in the literature for patients with calcific tendinitis who do not respond to conservative treatment.

Calcific tendinitis is a disease that occurs with the precipitation of hydroxyapatite crystals on tendons and shoulder region is the most involved. In the shoulder region, calcific tendinitis can involve all rotator cuff tendons, most commonly the supraspinatus. It may progress with pain and functional limitation. The pain can increase with movement or can occur at rest and sleep. The prevalence of calcific tendinitis is between 2.7% and 20% in the general population. The most common age group is between 30 and 60. It can negatively affect the family and social life of the person and cause loss of workforce.

Especially in the treatment of patients with calcific tendinitis unresponsive to conservative treatment, ultrasound-guided corticosteroid injection in subacromial bursa and ultrasound-guided lavage are frequently used treatment options. However, there are very few studies in the literature comparing these two treatment methods as randomized controlled trials.

In this study, it is aimed to compare the effectiveness of ultrasound guided subacromial bursa injection and ultrasound guided lavage procedures on pain scores, functional scales, disability scales, direct radiography findings and ultrasonographic imaging findings.

Inclusion Criteria:

• Cases diagnosed with calcific tendinitis who did not benefit from conservative treatment
• Cases with calcific deposits greater than 1 cm in direct radiography, ultrasonography, or magnetic resonance imaging
• Cases between the ages of 18-75 whose informed consent was obtained for participation in the study

Exclusion Criteria:

• Cases with radiculopathy ipsilateral to the affected shoulder
• Cases with active inflammatory arthropathy of the affected shoulder
• Cases with previous shoulder surgery
• Cases with a history of humeral head, scapula, and clavicle fractures
• Cases with neurological deficit affecting the upper extremity
• Cases with uncontrolled diabetes mellitus and uncontrolled hypertension, uncompensated congestive heart failure, chronic renal failure, chronic liver disease, tumor and/or vascular disease, inflammatory and/or infectious diseases, currently active psychiatric disease
• Cases with a history of subacromial bursa injection, calcific lavage or shoulder joint injection in the last 3 months
• Cases with a history of allergic reaction to the substance to be applied as local anesthetic
• Pregnancy or lactation
• Anticoagulant or antiagregant (antiplatelet) medication use that may interfere with the injection procedure.