Ultrasound-guided percutaneous irrigation of calcific tendinopathy: redefining predictors of treatment outcome
- PDF / 967,080 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 29 Downloads / 144 Views
MUSCULOSKELETAL
Ultrasound-guided percutaneous irrigation of calcific tendinopathy: redefining predictors of treatment outcome Evangelia E. Vassalou 1,2 & Michail E. Klontzas 1,3 & Athena P. Plagou 1,4 & Apostolos H. Karantanas 1,3,5 Received: 26 April 2020 / Revised: 19 August 2020 / Accepted: 21 September 2020 # European Society of Radiology 2020
Abstract Objectives To identify prognostic factors affecting the clinical outcome in patients treated with rotator cuff ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT), by evaluating the degree of calcium removal, the size and consistency of calcific deposits, and baseline level of shoulder pain and functionality. Methods From January 2017 to December 2019, 79 patients (23 males, 56 females; mean age, 45.7 years) who underwent US-PICT were prospectively enrolled. The calcifications’ location, consistency, and size were evaluated. For US-PICT, local anesthesia, lavage of calcific material, and intrabursal steroid injection were performed. The degree of calcium removal was graded as total/partial. Shoulder pain and functionality were assessed with the visual analogue scale (VAS) in all and Constant score (CS) in a subset of patients, respectively, at 4 time-points. Mann-Whitney U test, Fisher’s test, and linear and binary logistic regression were utilized for analysis. Results Pain improvement correlated with the presence of larger calcifications and lower baseline VAS score, at 1 week (p = 0.001, p < 0.001, respectively) and 1 year (p < 0.001, p = 0.002, respectively). Improved functionality correlated with total calcification retrieval, higher baseline CS, and fluid/soft calcific consistency at 1 week (p = 0.013, p = 0.003, p = 0.019, respectively). Increased calcification size, cystic appearance, and lower baseline VAS scores independently predicted complete pain resolution at 1 year. Conclusion Large calcifications and low-grade pain at baseline correlated with short- and long-term pain improvement. The degree of calcium removal did not impact pain or functional improvement beyond 1 week. Increased calcification size, cystic appearance, and low-grade baseline pain predicted complete pain recovery at 1 year. Key Points • The presence of larger calcifications and lower-grade baseline pain appear to correlate with pain improvement at 1 week and 1 year after ultrasound-guided irrigation of rotator cuff calcific tendinopathy (US-PICT). • Total calcification retrieval, less affected baseline shoulder functionality, and presence of fluid/soft consistency of calcific deposits appear to correlate with improved shoulder functionality at 1 week post-treatment. • Baseline pain intensity and calcifications’ morphologic characteristics, but not the degree of calcium retrieval, represent predictors of complete pain recovery at 1 year after US-PICT. Keywords Calcinosis . Tendinopathy . Therapeutic irrigation . Ultrasonography, Interventional . Rotator cuff
* Apostolos H. Karantanas [email protected]; [email protected] 1
Department of Medical Imagin
Data Loading...
