title: Evaluation of calcific tendonitis of the rotator cuff: role of color Doppler ultrasonography.
abstract: OBJECTIVE
  To use color Doppler ultrasonography to evaluate the morphology and vascularity of calcific tendonitis and to predict the formative and resorptive phases of the calcification.
  
  
  METHODS
  Ninety-four patients with shoulder calcification on plain radiographs were enrolled in this study. Ultrasonography of the shoulder was focused on the rotator cuff. Color Doppler ultrasonography was applied in the calcific region. Patient symptoms were graded as painless, mild, moderate, and severe. The calcific plaques were classified as arc-shaped, fragmented or punctate, nodular, and cystic types. Color Doppler ultrasonographic signals were graded 0 to 3. The formative and resorptive phases of calcification were categorized by patient symptoms; acute onset of moderate or severe pain indicated the resorptive phase.
  
  
  RESULTS
  The calcific plaques appeared arc shaped in 59 patients (20 painless, 19 mild, and 20 moderate), fragmented or punctate in 27 (2 painless, 3 mild, 20 moderate, and 2 severe), nodular in 6 (1 moderate and 5 severe), and cystic in 2 (severe). There was a significant difference between the morphology of the calcific plaques and clinical symptoms (P < .01). On color Doppler ultrasonography, grade 0 signals were found in 28 patients (22 painless and 6 with mild pain); grade 1 in 18 (16 mild and 2 severe); grade 2 in 41 (all moderate); and grade 3 in 7 (all severe). The correspondence between color Doppler ultrasonographic findings and clinical symptoms was excellent (P < .01).
  
  
  CONCLUSIONS
  High-resolution ultrasonography with color Doppler imaging could differentiate the formative and resorptive phases of the calcification and could be used as a follow-up modality in calcific tendonitis of the shoulder.
authors.affiliation: Department of Radiology, Veterans General Hospital-Taipei, School of Medicine, National Yang Ming University, Taiwan, Republic of China.
authors.forename: Hong-Jen
authors.initials: HJ
authors.lastname: Chiou
authors.forename: Yi-Hong
authors.initials: YH
authors.lastname: Chou
authors.forename: Jinn-Jer
authors.initials: JJ
authors.lastname: Wu
authors.forename: Chung-Chuen
authors.initials: CC
authors.lastname: Hsu
authors.forename: Da-Y
authors.initials: DY
authors.lastname: Huang
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chang
mesh_terms: D002114:Calcinosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff; D020069:Shoulder Pain / Q000175:diagnosis; D052256:Tendinopathy / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color