Klontzas Michail E, Vassalou Evangelia E, Karantanas Apostolos H
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.
Skeletal Radiol. 2017 Feb;46(2):201-208. doi: 10.1007/s00256-016-2538-9. Epub 2016 Dec 1.
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.
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.
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).
Outcomes of ultrasound-guided treatment in cases of RCCT with intraosseous extension are significantly less favourable than in purely tendinous or peritendinous disease.
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。
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。
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)。
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。