Extracorporeal shock wave therapy in calcific tendinitis of the shoulder.
OBJECTIVE
To investigate clinical (pain, mobility) and radiological (resolution of calcium deposits) efficacy of different energy levels of extracorporeal shock wave therapy (ESWT) in calcific tendinitis of the shoulder.


METHODS
There were 90 study subjects with radiographically verified calcific tendinitis of one shoulder, mean age 52+/-6 years (range 29-65 years; females:males=55:35), all of whom had had symptoms for at least 6 months and substantial restriction of shoulder mobility and pain that required taking anti-inflammatory drugs. Calcium deposits were of type I or type II (clearly circumscribed and dense) and ranged from 1 cm to 3 cm in diameter. Subjects were divided into three groups to receive ESWT at one of two energy levels (E1=0.15 mJ/mm2, E2=0.44 mJ/mm2) or sham treatment. Treatment was given at 6 weekly intervals until symptoms resolved, five treatments had been given or the subject dropped out of the programme.


RESULTS
All subjects in groups E1 and E2 completed the programme. Those in group E1 had significantly less pain during treatment but more treatments than those in group E2, and at 6 month follow-up had residual calcification and recurrence of pain (87%). Subjects in group E2 had no residual calcification or recurrence of pain. Sham treatment had no effect. There were no side effects except a small number of haematomas (2 in E1, 6 in E2; maximum size 2 cm).


CONCLUSIONS
ESWT in calcific tendinitis of the shoulder is very effective. It does not have significant side effects at an energy level of E=0.44 mJ/mm2, which can therefore be recommended.
Department of Radiology, Bethanien Krankenhaus, Im Pruefling 23, 60389 Frankfurt am Main, Germany. j.peters@em.uni-frankfurt.de
Jutta
J
Peters
Wolfgang
W
Luboldt
Wolfram
W
Schwarz
Volkmar
V
Jacobi
Christopher
C
Herzog
Thomas J
TJ
Vogl
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000473:pathology; D012785:Shoulder Joint; D052256:Tendinopathy / Q000628:therapy*; D016896:Treatment Outcome