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Sonographically guided percutaneous needle lavage and aspiration for the treatment of rotator cuff calcifications provides long-term pain relief and restored range of motion.

Sonographically guided percutaneous needle lavage and aspiration for the treatment of rotator cuff calcifications provides long-term pain relief and restored range of motion, according to a team of clinicians in Spain.

"Calcific tendinitis is common and is highly disabling," lead author Dr. Jose Luis del Cura remarked in a press release. "It usually involves middle-aged labor-active people and costs thousands of dollars in working hours lost."

Noting that there is no consensus regarding the best treatment of calcific tendinitis of the shoulder, Dr. del Cura and associates at the Hospital de Basurto in Bilbao prospectively evaluated outcomes for 67 shoulders in 65 patients treated percutaneously. They report their findings in the September online issue of the American Journal of Roentgenology.

In each case, conservative treatment (including anti-inflammatory drugs, local steroid injections, and rehabilitation) had been tried and failed. The authors' technique involves needle placement below the level of the calcification, and injection of one per cent lidocaine into the calcium deposit prior to aspiration. The procedure is performed only one time per calcification to prevent damage of a tendon.

Outcomes as measured by the Shoulder Pain and Disability Index showed significant improvement from baseline (mean 50.2 points) to ten weeks (mean 27.0) and at one year (14.7), Dr. del Cura's team reports.

Similar improvements were documented for shoulder range of motion and resolution of calcification on radiography (p < 0.0001 for all comparisons).
At the end of a year, substantial or complete clinical improvement was achieved in 91 per cent of shoulders. "These results are similar to the best results published for shockwave therapy and are not worse than those for surgery," the investigators state.

According to Dr. del Cura, "Percutaneous treatment is a simple, efficacious and inexpensive way to solve the problem, which can be performed in any health facility, requiring only a state-of-the-art ultrasound platform to perform it."

Am J Roentgenol 2007;189:W128W134.