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Ultrasound-Guided Percutaneous Therapy Effective for Shoulder Tendonitis

OAK BROOK, Ill -- June 30, 2009 -- A minimally invasive procedure to treat tendonitis in the rotator cuff of the shoulder provides immediate symptom relief to the patient, according to a study published in the July issue of the journal Radiology.

The study found that ultrasound-guided nonsurgical therapy significantly reduces pain from calcific tendonitis of the rotator cuff and restores lasting mobility after treatment.

"With this treatment, we were able to establish a single inexpensive and effective treatment for calcific tendonitis of the rotator cuff. This has never happened before," said co-author Luca M. Sconfienza, MD, Unit of Radiology, IRCCS Policlinico San Donato, University of Milan School of Medicine, Milan, Italy. "Symptoms improved in patients treated with our procedure compared to non-treated patients."

"This treatment could completely replace other treatments that are affected by several limitations and complications," Dr. Sconfienza said.

Ultrasound-guided percutaneous therapy represents an effective and inexpensive alternative to surgery that is less stressful for the patient.

For the 20-minute procedure, the shoulder is anesthetised and, with ultrasound guidance, a radiologist injects a saline solution into the rotator cuff to wash the area and break up the calcium. A second needle is used to aspirate, or withdraw, the calcium residue. Recovery time is about an hour.

"People with calcific tendonitis should know that with a simple, one-time ultrasound-guided procedure, they could recover completely from the terrible pain constantly affecting their shoulder," Dr. Sconfienza said.

For the study, Dr. Sconfienza, and senior author Giovanni Serafini, MD, Radiology Unit, Santa Corona Hospital, Pietra Ligure, Italy, and colleagues used ultrasound-guided percutaneous therapy to treat 235 shoulders in 133 women and 86 men (mean age, 42 years) with calcific tendonitis.

An additional 68 patients (31 men and 37 women) did not receive treatment and acted as a control group. All of the patients had shoulder pain that was unresponsive to previous medical treatment. Follow-up was conducted after 1 month, 3 months, 1 year, 5 years, and 10 years.

The results showed that treated patients exhibited a considerable reduction in pain and significant improvement to mobility of the affected limb after 1 month, 3 months, and 1 year compared with non-treated patients. Five and 10 years after the procedure, the condition of non-treated patients had improved to the point that reported outcomes were similar to those of the treated group.

While few institutions currently offer this therapy, Dr. Sconfienza says that, theoretically, the procedure could be performed in any hospital or clinic that has ultrasound equipment with a superficial probe.

SOURCE: Radiological Society of North America

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