Calcific tendonitis is relatively ...

Calcific tendonitis is relatively often met with and often self-limiting. Treatment is usually conservative and involves cortisone injections, anti-inflammatory medications, and physical therapy. For patients with chronic calcification, surgical removal of deposits has been helpful. Gerdesmeyer and colleagues compared extracorporeal hostile encounter wave therapy (ESWT) with placebo treatment to determine whether ultrasonography treatment can be proffered as an alternative to surgery

Patients were randomized at seven center to receive high-energy ESWT low-energy ESWT or sham treatment. Eligible patients were 18 years or older with at least six month of pain or tendernes from idiopathic model I or type II calcific tendonitis resistant to conservative treatment. They also had to have radiographic evidence of calcific deposits in the absence of rotator beat tears and subacromial bursitis. Primary issues were a change in function and pain score at six month with a 30 percent improvement defined as clinically relevant. Secondary finis points were changes in mean three- and 12-month scores and in self-rated pain at three six, and 12 month according to a visual analog scale, as well as interval radiographic assessment of demeanor and size of calcific deposits.

A total of 144 patients were treated, with 48 patients in each collection After six months, 10 patients were misspent to follow-up,with greater numbers wasted to follow-up after that. High- and low-energy treatments were superior to sham treatment after six month with pain and function scores showing similar follows Scores at other intervals did not change this finding. Patients in the high-energy arrange had significantly less pain by means of visual analog score than patients in the low-energy assign places to and both groups had les pain than patients in the sham treatment cluster at six months.

At other intervals, the low-energy and sham clusters were not statistically different in terminuss of the visual analog score. Radiographically, consummate disappearance of the calcific deposit was observ in 60 and 86 percent of the high-energy clump at six and 12 month respectively. unimpaired disappearance of deposits was observ in 11 and 25 percent of the placebo form into groups at six and 12 month respectively.

The authors end that high- and low-energy ESWT has significant clinical benefit compared with sham treatment, and that high-energy ESWT is associated with significantly better issues Because of high dropout rates, the data are more reliable at six month after treatment than at 12 month ESWT may be a les expensive treatment for chronic calcific shoulder tendonitis than surgery

Gerdesmeyer L et al. Extracorporeal clash wave therapy for the treatment of chronic calcifying tendonitis of the rotator stroke A randomized controlled trial. JAMA November 19 2003;290:2573-80

COPYRIGHT 2004 American Academy of Family Physicians

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