Skip to main content
SpringerLink
Log in

Double-needle ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis: tips & tricks

  • Review Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Rotator cuff calcific tendinitis is a very common disease and may result in a very painful shoulder. Aetiology of this disease is still poorly understood. When symptoms are mild, this disease may be treated conservatively. Several treatment options have been proposed. Among them, ultrasound-guided procedures have been recently described. All procedures use one or two needles to inject a fluid, to dissolve calcium and to aspirate it. In the present article, we review some tips and tricks that may be useful to improve performance of an ultrasound-guided double-needle procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Speed CA, Hazelman BL. Calcific tendinitis of the shoulder. N Engl J Med. 1999;340:1582–4.

    Article  PubMed  CAS  Google Scholar 

  2. Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment–nonrandomized controlled trial. Radiology. 2009;252:157–64.

    Article  PubMed  Google Scholar 

  3. Uhthoff HK, Sarkar K. Calcifying tendinitis. Baillieres Clin Rheumatol. 1989;3:567–81.

    Article  PubMed  CAS  Google Scholar 

  4. Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am. 2005;87:187–202.

    Article  PubMed  Google Scholar 

  5. Bianchi S, Martinoli C, Shoulder in Bianchi S, Martinoli C, eds. Ultrasound of the musculoskeletal system, Berlin, Germany: Springer-Verlag, 2007;190–331

  6. Hamada J, Ono W, Tamai K, Saotome K, Hoshino T. Analysis of calcium deposits in calcific periarthritis. J Rheumatol. 2001;28:809–13.

    PubMed  CAS  Google Scholar 

  7. Leduc BE, Caya J, Tremblay S, Bureau NJ, Dumont M. Treatment of calcifying tendinitis of the shoulder by acetic acid iontophoresis: a double-blind randomized controlled trial. Phys Med Rehabil. 2003;84:1523–7.

    Article  Google Scholar 

  8. Ebenbichler G. Ultrasound therapy for calcific tendinitis of the shoulder. N Engl J Med. 1999;340:1582–4.

    Article  Google Scholar 

  9. Mouzopoulos G, Stamatakos M, Mouzopoulos D, Tzurbakis M. Extracorporeal shock wave treatment for shoulder calcific tendonitis: a systematic review. Skeletal Radiol. 2007;36:803–11.

    Article  PubMed  CAS  Google Scholar 

  10. Wittenberg RH. Surgical or conservative treatment for chronic rotator cuff calcifying tendinitis—a matched-pair analysis of 100 patients. Arch Orthop Trauma Surg. 2001;121:56–9.

    Article  PubMed  CAS  Google Scholar 

  11. Rubenthaler F. Prospective randomized surgical treatments for calcifying tendinopathy. Clin Orthop Relat Res. 2003;410:278–84.

    Article  PubMed  Google Scholar 

  12. Comfort TH, Arafiles RP. Barbotage of the shoulder with image-intensified fluoroscopic control of needle placement for calcific tendinitis. Clin Orthop Relat Res. 1978;135:171–8.

    PubMed  Google Scholar 

  13. Bradley M, Bhamra MS, Robson MJ. Ultrasound guided aspiration of symptomatic supraspinatus calcific deposits. Br J Radiol. 1995;68:716–9.

    Article  PubMed  CAS  Google Scholar 

  14. Galletti S, Magnani M, Rotini R, et al. The echo-guided treatment of calcific tendinitis of the shoulder. Chir Organi Mov. 2004;89:319–23.

    PubMed  CAS  Google Scholar 

  15. Aina R, Cardinal E, Bureau NJ, Aubin B, Brassard P. Calcific shoulder tendinitis: treatment with modified US-guided fine-needle method. Radiology. 2001;221:455–61.

    Article  PubMed  CAS  Google Scholar 

  16. Farin PU, Rasanen H, Jaroma H, Harju A. Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage. Skeletal Radiol. 1996;25:551–4.

    Article  PubMed  CAS  Google Scholar 

  17. del Cura JL, Torre I, Zabala R. Legórburu A Sonographically guided percutaneous needle lavage in calcific tendinitis of the shoulder: short- and long-term results. AJR Am J Roentgenol. 2007;189:W128–34.

    Article  PubMed  Google Scholar 

  18. Sconfienza LM, Serafini G, Sardanelli F. Treatment of calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique. AJR Am J Roentgenol. 2011;197:W366.

    Article  PubMed  Google Scholar 

  19. Giacomoni P, Siliotto R. Echo-guided percutaneous treatment of chronic calcific tendinitis of the shoulder. Radiol Med (Torino). 1999;98:386–90.

    CAS  Google Scholar 

  20. Farin PU, Jaroma HJ. Sonographic findings of rotator cuff calcifications. J Ultrasound Med. 1995;14:7–14.

    PubMed  CAS  Google Scholar 

  21. Sconfienza LM, Bandirali M, Serafini G, et al. Rotator Cuff Calcific Tendinitis: Does Warm Saline Solution Improve the Short-term Outcome of Double-Needle US-guided Treatment? Radiology. 2012;262:560–6.

    Article  PubMed  Google Scholar 

  22. De Zordo T, Ahmad N, Ødegaard F, et al. US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons. Ultraschall Med. 2011;32:S117–23.

    Article  PubMed  Google Scholar 

  23. Fowler C, McCracken D. US probes—Risk of cross infection and ways to reduce it—Comparison of cleaning methods. Radiology. 1999;213:299–300.

    PubMed  CAS  Google Scholar 

  24. Weidner S, Kellner W, Kellner H. Interventional radiology and the musculoskeletal system. Best Pract Res Clin Rheumatol. 2004;18:945–56.

    Article  PubMed  Google Scholar 

  25. Caturelli E, Giacobbe A, Facciorusso D, et al. Free-hand technique with ordinary antisepsis in abdominal US-guided fine-needle punctures: three-year experience. Radiology. 1996;199:721–3.

    PubMed  CAS  Google Scholar 

  26. Niesel HC. Local anesthetics: maximum recommended doses. Anaesthesiol Reanim. 1997;22:60–2.

    PubMed  CAS  Google Scholar 

  27. De Smet AA. Ultrasound-guided injections and aspirations of the extremities. Semin Roentgenol. 2004;39:145–54.

    Article  PubMed  Google Scholar 

  28. del Cura JL. Ultrasound-guided therapeutic procedures in the musculoskeletal system. Curr Probl Diagn Radiol. 2008;37:203–18.

    Article  PubMed  Google Scholar 

  29. Wiberg E, Wiberg N, Holleman AF. Inorganic chemistry. London, England: Academic Press; 2001. p. 810–1.

    Google Scholar 

Download references

Conflict of Interest

Authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Servizio di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30-20097 San Donato Milanese, Milano, Italy

    Luca Maria Sconfienza, Alberto Aliprandi & Francesco Sardanelli

  2. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7-20122, Milano, Italy

    Sara Viganò

  3. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Viale Benedetto XV 6, 16132, Genova, Italy

    Chiara Martini

  4. Unità Operativa di Chirurgia della Spalla, IRCCS Policlinico San Donato, Via Morandi 30-20097 San Donato Milanese, Milano, Italy

    Pietro Randelli

  5. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Morandi 30-20097 San Donato Milanese, Milano, Italy

    Pietro Randelli & Francesco Sardanelli

  6. Servizio di Radiologia, Ospedale Santa Corona, ASL 2 Savonese, Via XXV Aprile 38-17037 Pietra Ligure, Savona, Italy

    Giovanni Serafini

Authors
  1. Luca Maria Sconfienza
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sara Viganò
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Martini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alberto Aliprandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pietro Randelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni Serafini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesco Sardanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Maria Sconfienza.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sconfienza, L.M., Viganò, S., Martini, C. et al. Double-needle ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis: tips & tricks. Skeletal Radiol 42, 19–24 (2013). https://doi.org/10.1007/s00256-012-1462-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-012-1462-x

Keywords

Search

Navigation