Keywords:
Lithotripsy, Percutaneous, Ultrasound, Anatomy, Interventional non-vascular, Musculoskeletal system, Education, Efficacy studies, Calcifications / Calculi, Outcomes
Authors:
A. Molinari1, E. Listo2, D. Schettini1, R. Podesta'1, N. GANDOLFO1; 1Genova/IT, 2Firenze/IT
DOI:
10.26044/essr2019/P-0118
Conclusion
Calcific tendinopathy has a high prevalence in the adult popolation and affects 2.5% to 7.3% of healthy shoulders and it is the cause of syntomatic painful shoulders in above 20% of cases.
Women are more frequently affected with a ratio of 3:1.
The tendons most damaged are the rotator cuff’s tendons,,
in particular the areas in which there’s a local hipoxiemia or metabolic factors that determine a change in the tendon’s fibres that conduces to a fibrocartilagineas metaplasia with deposition of calcium.
We have 4 stages in this process that corresponds at different US features; the first phase is determined by a local oxygen tension decrease and local pressure increase in the this area and it’s correlated with the formative phase of calcium deposit; this process,
called calcification of I type,
is visualized in US as an intratendinous hyperechoic focus with a posterior acoustic shadowing.
In the reabsorptive phase of calcifying tendinitis,
the deposit of calcium corresponds at the calcification of II or III type that appear as a hyperechoic focus with absent or isoecoic shadow that reflect a semiliquid content.
Double-needle US-guided percutaneous treatment has results to be effective,
with a significant acute pain relief in the most of the case (reduction of 70%) and with an excellent functional recovery. In addition,
the treatment has been successful in all patients,
with an excellent compliance due to the minimally invasive treatment and to the absence of periprocedural and post-treatment complications.