title: Calcifying tendonitis of the shoulder joint : predictive value of pretreatment sonography for the response to low-dose radiotherapy.
abstract: 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.
authors.affiliation: Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Adamietz
authors.affiliation: Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Schulz-Wendtland
authors.affiliation: Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Sedat
authors.initials: S
authors.lastname: Alibek
authors.affiliation: Radiologic Institute, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.affiliation: Department of Radiology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Sauer
authors.affiliation: Department of Radiology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ott
authors.affiliation: 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.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Keilholz
mesh_terms: 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