New treatment effective for patients with shoulder pain

September 24, 2007

Inflammation of a tendon triggered by calcium deposits, or calcific tendinitis, can effectively be treated with a simple and cost effective percutaneous method according to a recent study conducted by researchers from the Hospital de Basurto in Bilbao, Spain.

"We started treating calcific tendinitis as the result of the request of several members of our hospital staff that were suffering with this condition," said Jose Luis del Cura, MD, lead author of the study. "The results we obtained in these few cases encouraged us to offer this treatment to our patients. Later, in collaboration with the rheumatology department of our hospital, we conducted a study to evaluate the efficacy of the procedure," said Dr. del Cura.

The study consisted of 67 shoulders that were treated with sonographically guided percutaneous needle lavage i.e. injections of lydocaine or saline. According to the study, one year after treatment, 91% of shoulders had considerably or completely improved. Of the 67 shoulders treated, 64% had perfect motion and the calcifications had resolved completely or nearly completely in 89% of the patients.

"A significant amount of the patients (about half of them) experienced a transitory limited recurrence about two months after the treatment, which we found surprising," said Dr. del Cura. "When the recurrence did occur, the symptoms were different; milder and predominately at night, lasted several weeks and finally disappeared, usually without sequels. We hypothesized that this may have been the result of reparative changes inside the tendon," he said.

"The results showed us that aspiration and lavage is a very efficacious technique in the treatment of calcific tendinitis. Calcific tendinitis is common and is highly disabling," said Dr. del Cura. "It has a significant social impact since it usually involves middle-aged labor-active people and costs thousands of dollars in working hours lost. The alternatives to percutaneous treatment are surgery and shockwave therapy, where the latter requires dedicated equipment. Percutaneous treatment is a simple, efficacious and inexpensive way to solve the problem which can be performed in any health faculty, requiring only a state-of- art ultrasound platform to perform it," he said.
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The full results of this study appear in the September issue of the American Journal of Roentgenology, published by the American Roentgen Ray Society.

American College of Radiology

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