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Comparison of Ultrasound-Guided Lavage and Subacromial Bursa Injection for Calcific Tendinitis: A Prospective,
Nuri Tuğbay Yıldıran1, Bilge Çakır1, Tuğçe Özekli Mısırlıoğlu1
1Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.
Objective:
The aim of this study was to compare ultrasound (US)-guided subacromial bursa injection and US-guided lavage in calcific tendinitis with clinical and ultrasonographic findings.
Design:
Double-blind, block-randomized controlled study with a 1-month follow-up period.
Setting:
Physical medicine and rehabilitation department of a university hospital.
Participants:
Thirty-one patients with calcific tendinitis resistant to conservative treatment were included.
Interventions:
The first group (n=15) received both US-guided lavage and subacromial bursa injection, while the second group (n=16) received only US-guided subacromial bursa injection.
Main Outcome Measures:
Patients were evaluated at baseline and 1 month after the procedures. Clinical measures included the Constant Shoulder Score (CSS), Shoulder Disability Questionnaire (SDQ), Quick Disability of the Arm, Shoulder and Hand score, and pain intensity via the Numeric Rating Scale (NRS) for resting, movement, and night pain. Ultrasonographic measures included calcific deposit size, shape, acoustic shadowing, and power Doppler activity.
Results:
After treatment, both groups demonstrated significant improvements in CSS (subacromial bursa injection: +16.18±19.74; lavage: +17.06±9.78), SDQ (-26.67±30.14 vs -31.93±23.80) and Quick DASH (19.62±18.27 vs -29.39±17.51), with no intergroup differences (P>.05). A significant decrease in resting pain, assessed by the NRS, was observed only in the lavage group (3.00±2.96, P<.05), while the subacromial bursa injection group did not show a statistically significant change in resting pain (P>.05). No significant differences were found between the groups in NRS scores for pain during shoulder movement and night pain. Ultrasonographically, the lavage group demonstrated a significant reduction in deposit size (5.75±4.64cm, P<.01) and acoustic shadowing (P<.05), while the subacromial group showed no significant changes in these parameters (P>.05).
Conclusions:
Both treatment methods provided clinical improvement in the early period. However, lavage was significantly more effective in reducing resting pain, decreasing calcific deposit size, and minimizing acoustic shadowing on US.
