肩袖钙化性肌腱炎的长期演变：诊断 10 年后的临床和放射学评估。

Long-term evolution of calcific tendinitis of the rotator cuff: clinical and radiological evaluation 10 years after diagnosis.

机构信息

Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.

U.O.C. 1a Clinica Ortopedica, Azienda Socio Sanitaria Territoriale Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy.

出版信息

J Orthop Traumatol. 2021 Oct 26;22(1):42. doi: 10.1186/s10195-021-00604-9.

DOI:10.1186/s10195-021-00604-9

PMID:34698958

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8548447/

Abstract

BACKGROUND

Calcific tendinitis of the shoulder has a tendon involvement that could evolve to rotator cuff tear and shoulder osteoarthritis. This study aimed to evaluate the prevalence of glenohumeral osteoarthritis and rotator cuff tears in patients affected by calcific tendinitis at a minimum follow-up of 10 years after diagnosis.

METHODS

Patients diagnosed with calcific tendinitis of the shoulder with a minimum follow-up of 10 years were contacted and invited for a clinical and radiological evaluation. Information on the demographics, affected and dominant side, bilateral shoulder pain, type of treatment, habits, systemic or musculoskeletal diseases, reoperation of the index shoulder, and subjective satisfaction was collected. The clinical evaluation was performed using Constant-Murley score (CMS), American Shoulder and Elbow Surgeons Score (ASES), and numerical rating scale (NRS); isometric strength in forwarding flexion and abduction was also measured. Each patient also underwent an ultrasound examination to evaluate rotator cuff tendon integrity and a shoulder radiograph to evaluate osteoarthritis.

RESULTS

Seventy-nine patients were available for a phone interview, and 35 agreed to be examined. The mean age was 58.89 (± 7.9) years at follow-up. The prevalence of glenohumeral osteoarthritis was 17.14% in the study population, with significant progression in 14.29% of the cases, without rotator cuff full-thickness tears. x-Ray examination showed residual calcifications in 31 patients, with a mean diameter of 5.54 mm. In 30 cases, there was a reduction of the diameter; in 4 cases, the calcification increased in size; and in 1 case, the size did not change. The mean ASES score was 74.1 (± 22.7) in the group with calcifications larger than 2 mm and 89.4 (± 8.2) in patients with smaller calcifications (p = 0.08) without correlation with the type of treatment performed.

CONCLUSIONS

Calcific tendinitis is a self-resolving disease without rotator cuff tears at long-term follow-up or degenerative glenohumeral progression.

LEVEL OF EVIDENCE

3, cohort study.

摘要

背景

肩钙化性肌腱炎有肌腱受累，可发展为肩袖撕裂和肩关节炎。本研究旨在评估在诊断后至少 10 年的随访中，患有钙化性肌腱炎的患者的肩关节炎和肩袖撕裂的患病率。

方法

联系并邀请已确诊为肩钙化性肌腱炎且随访时间至少 10 年的患者进行临床和放射学评估。收集的信息包括人口统计学、受累和优势侧、双侧肩部疼痛、治疗类型、习惯、全身性或肌肉骨骼疾病、索引肩部的再手术以及主观满意度。临床评估采用 Constant-Murley 评分（CMS）、美国肩肘外科医生评分（ASES）和数字评分量表（NRS）进行；还测量了前屈和外展的等距力量。每位患者还接受了超声检查以评估肩袖肌腱完整性，并进行肩部 X 线检查以评估骨关节炎。

结果

79 名患者接受了电话采访，其中 35 名同意接受检查。随访时的平均年龄为 58.89（±7.9）岁。研究人群中肩关节炎的患病率为 17.14%，其中 14.29%的病例有明显进展，没有全层肩袖撕裂。X 线检查显示 31 名患者仍有钙化，平均直径为 5.54mm。在 30 例中，直径减小；在 4 例中，钙化增大；在 1 例中，大小不变。钙化直径大于 2mm 的患者的 ASES 评分平均为 74.1（±22.7），而钙化直径较小的患者为 89.4（±8.2）（p=0.08），与所进行的治疗类型无关。