Tactics choice of treatment of shoulder calcific tendinitis taking into account the phase of the disease
Summary. Calcific tendinitis is a fairly common disease of the shoulder joint with a characteristic accumulation of calcium hydroxyapatite in the tendons of the rotator cuff. This disease is accompanied by pain and functional disorders in the shoulder joint. The aim of the study – to form a method of individual approach in the choice of treatment tactics of this disease on the basis of clinical manifestations and results of additional research methods and to evaluate the results. Materials and Methods. Examination and treatment of 74 patients with calcific tendonitis of the rotator cuff were performed. The mean age of patients was (45.4±1.3); there were 28 (37.84 %) men, and 46 (62.16 %) women. The examination included: general clinical and instrumental methods of study, namely -- examination of the patient with functional tests for the shoulder joint, radiography, sonography, with indications – magnetic resonance imaging. Results. Treatment was selected as individually as possible for each patient taking into account phases of the disease. Clinical and sonographic recovery was noted in 33 (62.27 %) people in 2 weeks after treatment. Surgical treatment under arthroscopic control was performed in 10 (13.51 %) patients. Conclusions. Treatment should be selected individually for each patient, taking into account the phase of the disease and include non-steroidal anti-inflammatory drugs, non-benzodiazepine antispasmodics, needling with local anesthetics and prolonged glucocorticoids, cryotherapy and physical therapy
shoulder joint, calcific tendinitis, rotator cuff, radiography, sonography, MRI, needling
https://doi.org/10.11603/bmbr.2706-6290.2021.3.12230[1] De Palma AF, Kruper JS. Long-term study of shoulder joints affected with and treated for calcific tendinitis. Clin Orthop. 1961;20: 61-72. Available from: PMID: 13721957.
[2] Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;(214): 160-4. Available from: PMID: 3791738.
[3] Diehl P, Gerdesmeyer L, Gollwitzer H, Sauer W, Tischer T. Calcific tendinitis of the shoulder. Orthopade. 2011;40(8): 733-46. DOI: 10.1007/s00132-011-1817-3.
[4] Fernández-Cuadros ME, Pérez-Moro OS, Nieto-Blasco J, Rivera-García V, Olazar-Pardeiro A. Calcifying tendinitis of the shoulder: risk factors and effectiveness of physical therapy. Occup Med Health Aff. 2015;3(6): 2. Available from: https://doi.org/10.4172/2329-6879.1000220.
[5] Fusaro I, Orsini S, Diani S, Saffioti G, Zaccarelli L, Galletti S. Functional results in calcific tendinitis of the shoulder treated with rehabilitation after ultrasonic-guided approach. Musculoskelet Surg. 2011;95(Suppl.1): S31-S36. DOI: 10.4172/2329-6879.1000220.
[6] Gärtner J, Heyer A. Calcific tendinitis of the shoulder. Orthopade. 1995;24(3): 284-302. DOI: 10.1007/s12306-011-0119-6.
[7] Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS Pain), numeric rating scale for pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63(Suppl.11): 240-52. Available from: PMID: 7617385.
[8] Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR. Normalization of the Constant score. J Shoulder Elbow Surg. 2005;14(3): 279-85. DOI:10.1016/j.jse.2004.10.009.
[9] Krasny C, Enenkel M, Aigner N, Wlk M, Landsiedl F. Ultrasound-guided needling combined with shock-wave therapy for the treatment of calcifying tendonitis of the shoulder. J Bone J Surg Br. 2005;87(4): 501-17. DOI:10.1016/j.jse.2004.10.009.
[10] Refior H, Krödel A, Melzer C. Examinations of the pathology of the rotator cuff. Arch Orthop Trauma Surg. 1987;106(5): 301-8. DOI: 10.1007/BF00454338.
[11] Sconfienza LM, Bandirali M, Serafini G, Lacelli F, Aliprandi A, Di Leo G, Sardanelli F. Rotator cuff calcific tendinitis: does warm saline solution improve the short-term outcome of double-needle US-guided treatment? Radiology. 2012;262(2): 560-6. DOI:10.1148/radiol.11111157.
[12] Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: shortterm and 10-year outcomes after two-needle US-guided percutaneous treatment–nonrandomized controlled trial. Radiology. 2009;252(1): 157-64. DOI:10.1148/radiol.2521081816.
[13] Speed CA, Hazleman BL. Calcific tendinitis of the shoulder. N Engl J Med. 1999;340(20): 1582-4. DOI: 10.1056/NEJM199905203402011.
[14] Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis and management. J Am Acad Orthop Surg. 1997;5(4): 183-91. DOI :10.5435/00124635-199707000-00001.