New ultrasound-guided treatment reduces pain from calcific rotator cuff tendonitis

The experimental technique uses saline injected into the rotator cuff to break up calcium deposits.

A new ultrasound-guided non-surgical therapy significantly reduces pain from calcific rotator cuff tendonitis and restores mobility, according to a study presented at the annual meeting of the Radiological Society of North America.

"This is a quick, successful and inexpensive therapy for tendon calcifications," said Luca M. Sconfienza, MD, from the Department of Radiology at A.O. Ospedale Santa Corona in Pietra Ligure and the Department of Experimental Medicine at the University of Genova in Italy, in a press release. "It provides significant and long-lasting reduction of symptoms."

During ultrasound-guided percutaneous therapy, once the shoulder is anesthetized, a saline solution is injected into the rotator cuff to wash the area and break up the calcium deposits. A second needle is then used to aspirate the calcium residue.

The procedure takes about 10 minutes to perform, and patients require about 1 hour postoperative recovery. Also, calcifications that are completely removed do not return, according to the release.

Sconfienza and colleagues evaluated the technique in a study involving 2,543 shoulders in 1,607 women and 936 men who had calcific tendonitis at an average age of 42 years. All patients had shoulder pain that had not responded to previous medical treatment.

One-year follow-up data were reported for 2,018 patients.

Investigators found that a single treatment fully removed the calcification in 71.7% of patients, providing a considerable reduction in pain and significant improvement in mobility of the affected limb.

A second procedure was performed in 23.6% of patients who had more than one calcification.

In 3.8% of patients, the calcification had either dissolved or moved to the subacromial-subdeltoid bursa before treatment could be performed. Also, 0.9% of patients had no improvement in symptoms due to a tendon tear, according to the study.

While Ospedale Santa Corona and the University of Genova are among few institutions currently offering the treatment, Sconfienza said that theoretically the procedure could be performed in any center that has ultrasound equipment with a superficial probe.

For more information:

• Sconfienza LM, Gravano M, Silvestri E, et al. Ultrasound (US)-guided percutaneous approach to the therapy of calcific tendonitis of rotator cuff. Presented at the Radiological Society of North America annual meeting. Nov. 25-30, 2007. Chicago.