[Tendinosis calcarea--results of treatment with needling]

In a prospective study, 33 patients with calcifying tendinitis had a needling in local anaesthesia performed under control of an image converter. There was at least a one year follow-up period. Resorption of the hydroxyapatite deposits was seen in 23 instances; 75% of all patients were free of symptoms or had considerably improved (Table 3). For better assessment of these results we embarked on an additional retrospective study observing the spontaneous evolution of 235 hydroxyapatite deposits for 3 years on average. On the x-ray, these deposits had a characteristic appearance and could be classified into one of three types: either sharply outlined and densely structured (type I), or with cloudy limitations and transparent in structure (type III). In addition we saw deposits combining the features of both of the above named types (type II) (Table 5, Fig. 6). Based on this classification, a clear correlation was revealed to exist between initial x-ray findings and the frequency of resorption after needling: with type I, complete resorption was seen in 33% of the cases, with type II in 71%, and with type III in 85% of the cases (Table 6). With type II, however, only half of the patients were free of symptoms. Surgical removal of the hydroxyapatite deposits became necessary in 3 patients because of persisting heavy pains. As complication we observed intraoperatively an incomplete tear of the rotator cuff, the relation of which to the needling remained unsure. In this context, the question is discussed whether calcifying tendinitis and rupture of the rotator cuff may represent two disease entities of identical origin.(ABSTRACT TRUNCATED AT 250 WORDS)