Shockwave therapy under ultrasonographic guidance in rotator cuff calcific tendinitis

This is the first efficacy evaluation in patients with rotator cuff calcific tendinitis treated with shockwave therapy delivered using a dedicated extracorporeal lithotripter and ultrasonographic guidance.

Thirty-two patients with rotator cuff calcific tendinitis received shockwave therapy delivered using a lithotripter specifically designed for the musculoskeletal system (DORNIER EPOS ULTRA), under ultrasonography guidance (which is not part of the conventional procedure). The cumulative dose per patient was 1300 mJ/mm2 divided in two or three sessions. Three, six, 12, and 24 weeks after treatment, the patients were evaluated using a visual analog scale for pain, the ASES self-questionnaire, Constant's score, and plain radiographs.

Improvements in the pain and self-questionnaire scores were noted in 36.6% of patients after 12 weeks and 55.1% after 24 weeks. Plain radiographs were changed in 26.6% of patients after 12 weeks (with complete clearance of the calcific deposits in 6.6%) and in 24.1% of patients after 24 weeks (complete clearance in 17.2%).

These results seem less favorable than those reported with dedicated lithotripters and computed tomography guidance.