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伴有骨内延伸的肩部钙化性肌腱炎:超声引导下经皮冲洗的结果

Calcific tendinopathy of the shoulder with intraosseous extension: outcomes of ultrasound-guided percutaneous irrigation.

作者信息

Klontzas Michail E, Vassalou Evangelia E, Karantanas Apostolos H

机构信息

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.

出版信息

Skeletal Radiol. 2017 Feb;46(2):201-208. doi: 10.1007/s00256-016-2538-9. Epub 2016 Dec 1.

Abstract

OBJECTIVES

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.

MATERIALS AND 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).

CONCLUSION

Outcomes of ultrasound-guided treatment in cases of RCCT with intraosseous extension are significantly less favourable than in purely tendinous or peritendinous disease.

摘要

目的

伴有骨内扩展的肩袖钙化性肌腱病(RCCT)是肌腱及肌腱周围受累的一种罕见并发症。我们研究的目的是评估超声引导下经皮钙化性肌腱病冲洗术(US-PICT)对伴有骨内受累患者的治疗效果。

材料与方法

2011年1月至2014年6月,对临床及影像学诊断为RCCT的患者,根据影像学表现前瞻性地分为两组:A组(10例患者)为伴有骨内RCCT的患者,B组(对照组35例患者)为无骨受累的患者。A组和B组的所有患者均接受US-PICT,随后进行肩峰下注射。在1年的随访期间,使用四级评分量表在3周、3个月、6个月和1年时评估疼痛和功能改善方面的治疗效果。本研究已获得我院伦理委员会批准。

结果

在所有时间点,A组的平均改善评分均显著低于B组(p < 0.0001)。B组的改善主要在治疗后的前3个月内出现(p = 0.016)。

结论

伴有骨内扩展的RCCT患者,超声引导下治疗的效果明显不如单纯肌腱或肌腱周围疾病患者。

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