Calcifying tendonitis of the shoulder joint : predictive value of pretreatment sonography for the response to low-dose radiotherapy.
OBJECTIVE
Calcifying tendonitis is a degenerative inflammatory joint disorder. Pain relief can be successfully achieved with low-dose radiotherapy. It is actually unknown which types of calcifying tendonitis respond to radiotherapy and which do not. The authors tried to get predictive objectives for the response to radiotherapy on the basis of different morphological patterns of calcifications evaluated by X-ray and ultrasound.


METHODS
Between August 1999 and September 2002, a total of 102 patients with 115 painful shoulder joints underwent low-dose radiotherapy. At the beginning of radiotherapy, every shoulder joint was examined with a radiograph in two planes. In addition, sonography was performed before and during therapy. This examination was repeated 6 and 18 months after irradiation. Radiotherapy consisted of two series with a total dose of 6.0 Gy. 29 joints with calcifying tendonitis could be further divided using the sonographic and radiographic classification according to Farin and Gärtner, respectively.


RESULTS
Pain relief was achieved in 94/115 joints (82%) at a follow-up of 18 months (median). A different response to radiotherapy was found using the sonographic classification of Farin: calcifying tendonitis type III (n = 18) responded well in contrast to a significantly worse result in type I (n = 11). The radiologic classification did not provide a predictive value.


CONCLUSIONS
Sonographic classification of calcifying tendonitis is predictive for the outcome after radiotherapy. Especially patients with Farin type III calcification will benefit from low-dose radiotherapy.
Adamietz
Boris
B
Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
Schulz-Wendtland
Rüdiger
R
Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
Alibek
Sedat
S
Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
Uder
Michael
M
Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
Sauer
Rolf
R
Department of Radiology, University Hospital Erlangen, Erlangen, Germany.
Ott
Oliver
O
Department of Radiology, University Hospital Erlangen, Erlangen, Germany.
Keilholz
Ludwig
L
Department of Radiology, University Hospital Erlangen, Erlangen, Germany. ludwig.keilholz@klinikum-bayreuth.de.|Department of Radiotherapy, Klinikum Bayreuth GmbH, Bayreuth, Germany. ludwig.keilholz@klinikum-bayreuth.de.|Klinik für Strahlentherapie, Klinikum Bayreuth GmbH, Preuschwitzer Straße 101, 95445, Bayreuth, Germany. ludwig.keilholz@klinikum-bayreuth.de.
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000145:classification / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000528:radiation effects; D011379:Prognosis; D011879:Radiotherapy Dosage; D019534:Shoulder Impingement Syndrome / Q000145:classification / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000528:radiation effects*; D020069:Shoulder Pain / Q000145:classification / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D052256:Tendinopathy / Q000145:classification / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D016896:Treatment Outcome; D014463:Ultrasonography