• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.74-78
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• 2009

Purpose: To evaluate the effectiveness of ultrasonography-guided multiple needling for calcific tendinitis of the shoulder. Materials and Methods: We included 18 symptomatic calcific tendinitis patients who underwent ultrasonography-guided multiple needling and followed for average 17 weeks. The procedures were multiple needling or aspiration of the calcific deposit and injection of local anesthetics and steroid into the subacromial bursa under the ultrasound control. Clinical improvements were evaluated using pain VAS, UCLA score and KSS score. The size and status of calcific deposits were compared. Results: A significant improvement was seen in pain VAS, UCLA score and KSS score (p<0.05). At the final follow up, the calcific deposits had resolved completely of nearly completely in 39%, and the size was decreased in 61%. Conclusion: Ultrasound-guided multiple needling is considered as a useful method which could provide prompt pain relief and reduce calcific deposit for calcific tendinitis of the shoulder.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.94-98
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• 2012

Calcific tendinitis is characterized by inflammation around calcium hydroxyapatite crystal deposits. Minimally invasive extracorporeal shock wave therapy (ESWT) has been postulated to be an effective treatment option for treating calcific tendinitis. In clinical practice, shock waves usually are aimed at the painful area after palpation and not focused. It has been known that exact fluoroscopic focusing of ESWT at the calcific deposit for treatment of calcifying tendinopathy is highly effective. Ultrasound is a simple, inexpensive and radiation-free diagnostic tool that has been used to demonstrate tendinopathy including calcific tendinitis. However, focusing of shock wave under ultrasound is less well established. We present a patient in whom large calcific tendinitis of gluteus medius was completely resolved by exact focusing of ESWT by ultrasound with literature review.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.84-88
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• 2011

Purpose: We report here on two cases of calcific tendinitis at the origin of the common extensor tendons of the forearm. Materials and Methods: A 42 year-old female complained of left elbow pain and flexion contracture. After obtaining the simple radiographs and MRI, surgical excision of the calcific deposits was done under the diagnosis of calcific tendinitis. A 25 year-old female complained of right elbow pain and a limited range of motion. Simple radiographs showed a calcific deposit just distal to the lateral epicondyle, and then she was managed with extracorporeal shock wave therapy. Results: The pain disappeared completely and both patients regained a full range of motion after treatments. Conclusion: Calcific tendinitis at the origin of the common extensor tendons of the forearm should be included in the differential diagnosis of the lateral elbow diseases that cause pain and a limited range of motion.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.35-40
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• 2004

Purpose: The aim of this study was to investigate effects of calcific lesion on shockwave therapy of the tennis elbow. Materials and Methods: twenty-four patients with refractory tennis elbow were treated with shock waves. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of clinical outcomes for the patients with and without calcification in the extensor tendon and/or cortical irregularity of lateral condyle was tried to determine if this could be a possible prognostic factor in clinical settings. Overall clinical outcomes were evaluated by Roles and Maudsley score at 12 months after ESWT. Results: Significant improvement of symptoms were observed in 20 (83 %) patients at 12 months follow up according to Roles and Maudesley scores. The patients with calcification and/or cortical irregularity improved significantly better, when compared to the patients without calcification and/or cortical irregularity at follow up. Conclusion: This study suggests that shock waves therapy could be considered as effective and noninvasive treatment modality for refractory tennis elbow. Also calcific deposit in extensor tendon and/or cortical irregularity of the lateral epicondyle was seem to be good prognostic factor for shock wave therapy for tennis elbow

• Clinical Pain
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• v.18 no.2
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• pp.138-141
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• 2019

Lateral epicondylopathy represents pain in the lateral (radial aspect) of the elbow caused by degeneration in the common extensor tendon. Calcium deposit frequently developes in lateral epicondylopathy, with the prevalence up to 46%. There are considerable debates on its treatment protocols for lateral epicondylopathy so far, likewise, the effective treatment method for calcific lateral epicondylopathy has not been established. We report here a case of chronic intractable calcific lateral epicondylopathy treated with ultrasound-guided barbotage and focused type extracorporeal shock wave therapy (ESWT). To our knowledge, this is the first report of calcific lateral epicondylopathy treated by ultrasound-guided barbotage combined with ESWT.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.13-19
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• 2014

Purpose: To evaluate the effectiveness of ultrasonography-guided combined multiple needling and high-energy extracorporeal shock wave therapy (ESWT) for calcific tendinitis of the shoulder. Materials and Methods: We included 42 calcific tendinitis patients who underwent ultrasonograpy-guided multiple needling followed by high-energy ESWT who visited the clinic from January 2010 to June 2013. The average follow up period was 45 weeks. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using pain visual analogue scale (P-VAS), ASES, UCLA scores reflecting performance and symptom improvement, and in sonographic terms by studying the changes in size of the calcific nodules. Results: A statistically significant improvement was seen in P-VAS, ASES, UCLA scores and decreased calcification size on sonographic evaluation. Conclusion: Ultrasonography-guided combined multiple needling and high-energy ESWT is considered as a useful method which could provide clinical function improvement and reduction of calcification deposit.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.77-83
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• 2011

Purpose: We compared with USG-guided steroid injection group and blind steroid injection group for the treatment of calcific tendinitis to evaluate the effectiveness of the treatment modalities. Materials and Methods: We reviewed two groups of calcific tendinitis treated with steroid injection and follow up upto 6 month after injection. Group I was blind injection for 88 patient with average age of 53years old and female gender in 77%. Group II was USG- guided injection for 102 patients with average age of 54years old and female gender in 85%. We compared follow up results according to age, gender, size of tendon involvement, initial VAS score, and phase of the calcific tendinitis between two groups. Results: At 6 month's follow up period, USG-guided injected group was more prevalent compared to blind injection group with 92%(94/102) and 72%(64/88) (P<0.05). In Group I, 77%(49/64) patients have improved symptom. And in Group II, 92%(86/94) patients have improved symptom in formative or resorptive phase. Despite of symptom improvement, calcium deposit is remained 47%(30/64) in Group I, and 20%(19/94) in Group II. Conclusion: Conservative treatment of Shoulder calcific tendinitis patients through USG-guided injection is more effective than Blind injection in pain relief & calcium decrease. The patients USG-guided injected group was more prevalent in follow up at outpatient clinic, throughout more accurate injection with improved confidence.