CALCIFIC TENDINITIS OF THE ROTATOR CUFF Etiology The term “calcific tendinitis” refers to the intratendinousdeposition of calcium, predominantlyhydroxyapatite, that can affect every tendon inthe body and especially the rotator cuff. Thispathological condition is a dynamic processthat evolves through pre-calcific and calcific (formative, resorptive, reconstitutive) stages (Fig.1). In the precalcificstage, microtraumatic factors associatedwith a local decrease in blood supply can leadto intratendinous fibrocartilaginous metaplasia,with resulting calcification. The subsequent formative phase is considered as a resting period. Eventually, triggered by unknown factors, thereis resorption of the deposit,...

IRB approval and patients’ informed consent were obtained. 100 patients(77 females and 23 males, mean age 46years, range 32-70y)with RCCT(single calcification, acute/post-acute phase, no tendon tears)were randomized into two groups andweretreated with two different US-guided percutaneoustecniques. Group A (50 patients; mean visual analogue scale [VAS]=7.8) was treated using an US-guided 16G double-needle technique (local anesthesia, washing with warm saline, intrabursal steroid injection), while group B (50 patients; mean VAS=7.4) was treated using a 16G single-needle technique (local anesthesia, washing with warm saline, intrabursal steroid injection)....

The calcifications we treated in group A were: 4 fluid, 25 soft, 21 hard (mean dimension 23±5 mm) The calcifications we treated in group B were: 6 fluid, 27 soft, 17 hard (mean dimension 21±6 mm). We have had a drop-out of 3 patients from group B (2nd needle insertion). Overall procedure duration in group A (489±88s) was significantly shorter (P<.001) than in group B (684±187s). Difference in procedure duration in group A (489±88s ) was significantly lower than in group B (684±187s; P<0.001 )...

Single- and double-needle procedures are equally effective in treating RCCT with no major complications. Double-needle procedure allows for significantly reducing treatment time and appears to be much easier when dealing with soft and hard calcium deposits. Improvement in ease of calcium dissolution with double-needle technique when dealing with harder calcifications. Single needle could be dedicated to acute phase and double needle for harder chronic phase.

G. Ferrero,Department of Radiology, University of Genoa. ([email protected])

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