The role of high-resolution ultrasonography in management of calcific tendonitis of the rotator cuff

This article predicts the possibility of resorption of the calcific plaques in the shoulder using high-resolution ultrasonography (HRUS) and color Dop pler ultrasound (CDUS), and evaluates the therapeutic effect of US-guided f ine-needle multiple punctures of the calcific plaque, A total of 100 patien ts with calcific tendenosis were divided into 3 groups: In group 1, patient s having chronic shoulder pain received conservative treatment; in group 2, patients having acute exacerbation of shoulder pain also received conserva tive treatment; and group 3 patients received US-guided fine-needle multipl e punctures or aspiration, In CDUS, all images were classified as grade 0 ( no color how signals), grade 1 (weak spotty color flow signal), grade 2 (fe w rod-like color flow signals), grade 3 (many rod-like or linear color flow signals). In the follow-up study, marked improvement of patients' clinical condition with more than 50% size reduction of calcific plaque was defined as an effective treatment. There was no significant difference between gro up I and group 3 (p = 0.558) in CDUS, but there was a significant differenc e between group 1 and group 2 (p = 0.000), and group 2 and group 3 (p = 0.0 00) on the basis of classification of grade < 1 and grade greater than or e qual to 1, There was also significant difference in the follow-up result of effective management between group 1 and group 3 (p = 0.000), and group 1 and group 2 (p = 0.000). In conclusion, HRUS with CDUS proved to be a good modality in evaluating the possibility of resorption of shoulder calcificat ion and, if CDUS < grade 1 in calcific tendonitis, we highly recommend cons ervative treatment with regular follow-up, On the other hand, if CDUS < gra de 1, fine-needle repeated puncture could be considered as an effective alt ernative treatment. (C) 2001 World Federation for Ultrasound in Medicine & Biology.