title: Calcific tendinopathy of the shoulder with intraosseous extension: outcomes of ultrasound-guided percutaneous irrigation.
abstract: OBJECTIVE
  Rotator cuff calcific tendinopathy (RCCT) with intraosseous extension is a rare complication of tendinous and peritendinous involvement. The purpose of our study is to evaluate the outcome of ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) in patients with intraosseous involvement.
  
  
  METHODS
  From January 2011 to June 2014, patients with a clinical and imaging diagnosis of RCCT were prospectively categorised in two groups based on imaging findings: group A (10 patients) with intraosseous RCCT and group B (control group 35 patients) without osseous involvement. US-PICT followed by subacromial injection was applied to all patients in groups A and B. During a 1-year follow-up, treatment outcome in terms of pain and functional improvement was evaluated at 3 weeks, 3 months, 6 months, and 1 year, with the use of a four-grade scale. The study has been approved by our hospital's ethics committee.
  
  
  RESULTS
  Mean improvement scores of group A were significantly lower than those of group B at all time points (p < 0.0001). Improvement of group B was noted mainly within the first 3 months post-treatment (p = 0.016).
  
  
  CONCLUSIONS
  Outcomes of ultrasound-guided treatment in cases of RCCT with intraosseous extension are significantly less favourable than in purely tendinous or peritendinous disease.
authors.affiliation: Department of Medical Imaging, University Hospital and Department of Radiology, University of Crete, 71110, Heraklion, Crete, Greece.|Department of Chemical Engineering, Imperial College London, London, UK.
authors.forename: Michail E
authors.initials: ME
authors.lastname: Klontzas
authors.affiliation: Department of Medical Imaging, University Hospital and Department of Radiology, University of Crete, 71110, Heraklion, Crete, Greece.
authors.forename: Evangelia E
authors.initials: EE
authors.lastname: Vassalou
authors.affiliation: Department of Medical Imaging, University Hospital and Department of Radiology, University of Crete, 71110, Heraklion, Crete, Greece. akarantanas@gmail.com.
authors.forename: Apostolos H
authors.initials: AH
authors.lastname: Karantanas
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging*; D020069:Shoulder Pain / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D007507:Therapeutic Irrigation; D018084:Ultrasonography, Interventional
keywords: Calcifications; Hydroxyapatite deposition disease/treatment; Intraosseous; MRI diagnosis; Rotator cuff calcific tendinopathy treatment; Shoulder; Ultrasonography