• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.74-74
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• 2009

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.31-35
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• 2012

Calcific tendinitis usually occurs within the area where tendon inserts to bone. In the shoulder joints, most cases occur within the supraspinatus tendon just proximal to the greater tuberosity. We report a rare case of calcific tendinitis occurred within the conjoined tendon of coracobrachialis and short head of biceps brachii in a patient with rheumatoid arthritis, diagnosed by means of ultrasonographic evaluation.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.89-93
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• 2012

Although calcific tendinitis around hip joint is a rare condition, patients with symptomatic calcific tendinitis serve very severe pain and are disturbed their daily activities. We report four calcific tendinitis patients who had acute pain around the hip with limitation of motion of the joint and were treated with ultrasonography-guided multiple needling with dramatic pain relief.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.98-101
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• 2008

Purpose: To evaluate the results of arthroscopic removal of calcific deposit depending on the phase-dependent progress of recalcitrant calcific tendinitis of the shoulder. Materials and Methods: From January, 2003 to September, 2007, arthroscopic treatment of calcific tendinitis of the shoulder joint, especially supraspinatus was performed in 27 consecutive patients who had had typical symptoms and failed with the conservative treatment and all patients could be followed up at least 6 months. We evaluated the visual analogue scale at preoperative, postoperative 2 weeks and 6 months. The results were compared according to the arthroscopic findings. Results: 11 cases were chalky calcium deposit of arthroscopic finding and 16 cases were toothpaste-like appearance. The VAS was 8.0 of the group with chalky deposit and 8.3 with toothpaste-like deposit preoperatively, which was not significantly different. However, at postoperative 2 weeks, it was 6.7 with chalky deposit and 2.7 with toothpaste-like, which is significantly different. At postoperative 6 months, the symptoms of all patients were resolved. Conclusion: Resorptive phase is well respond to surgical excision at early postoperative evaluation. The phase of calcific tendinitis is one of important factors for rapid resolution of the shoulder pain and functional improvement after arthroscopic treatment.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.74-78
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• 2009

Purpose: To evaluate the effectiveness of ultrasonography-guided multiple needling for calcific tendinitis of the shoulder. Materials and Methods: We included 18 symptomatic calcific tendinitis patients who underwent ultrasonography-guided multiple needling and followed for average 17 weeks. The procedures were multiple needling or aspiration of the calcific deposit and injection of local anesthetics and steroid into the subacromial bursa under the ultrasound control. Clinical improvements were evaluated using pain VAS, UCLA score and KSS score. The size and status of calcific deposits were compared. Results: A significant improvement was seen in pain VAS, UCLA score and KSS score (p<0.05). At the final follow up, the calcific deposits had resolved completely of nearly completely in 39%, and the size was decreased in 61%. Conclusion: Ultrasound-guided multiple needling is considered as a useful method which could provide prompt pain relief and reduce calcific deposit for calcific tendinitis of the shoulder.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.13-19
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• 2014

Purpose: To evaluate the effectiveness of ultrasonography-guided combined multiple needling and high-energy extracorporeal shock wave therapy (ESWT) for calcific tendinitis of the shoulder. Materials and Methods: We included 42 calcific tendinitis patients who underwent ultrasonograpy-guided multiple needling followed by high-energy ESWT who visited the clinic from January 2010 to June 2013. The average follow up period was 45 weeks. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using pain visual analogue scale (P-VAS), ASES, UCLA scores reflecting performance and symptom improvement, and in sonographic terms by studying the changes in size of the calcific nodules. Results: A statistically significant improvement was seen in P-VAS, ASES, UCLA scores and decreased calcification size on sonographic evaluation. Conclusion: Ultrasonography-guided combined multiple needling and high-energy ESWT is considered as a useful method which could provide clinical function improvement and reduction of calcification deposit.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.66-74
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• 2012

Purpose: To compare the outcome of two methods of chronic calcific tendinitis (CCT) treatment, Multiple drilling alone versus combined drilling and extracorporeal shock-wave therapy (ESWT). Furthermore, to analyze the clinical and radiologic results of different energy level configurations of ESWT. Materials and Methods: Among the patients complaining shoulder pain who visited the clinic from June 2010 to August 2011, 98 were diagnosed with CCT of the supraspinatus and were divided into the following three groups. Multiple drilling alone (n=31), Multiple drilling followed by high-energy ESWT (n=31), Multiple drilling followed by low-energy ESWT (n=36). The study was conducted only with patients with chronic pain persisting longer than six months despite prolonged conservative therapy. Clinical evaluation was done before and after 12 weeks from treatment, in clinical terms using the ASES, KSS, CSS system reflecting performance and symptom improvement, and in radiologic terms by studying the change in size of the calcific nodules. Results: All of three groups showed effects for improvement of clinical function and decrease of calcification and clinical improvement was significantly high in comparison between the group fulfilled by only multiple needling (the third group) and the group fulfilled by additional ESWT (the first and second groups) and in the radiological evaluation, calcification size and the rate of calcification decrease showed significant improvement statistically. For the comparison among the groups, degree of clinical function improvement and rate of calcification decrease showed significant difference between high energy group (the first group) and multiple needling group (the third group) as well as low energy group (the second group) and multiple needling group (the third group). But, in comparison between high energy group (the first group) and low energy group (the second group), there was no significant difference for the degree of clinical function improvement and rate of calcification decrease. Conclusion: For the treatment of chronic calcific tendinitis, additional ESWT showed more superior effects on clinical function improvement and radiological improvement regardless of the energy standard rather than the exclusive fulfillment of needling. But, as the result of ESWT by the energy standard, there was no significant difference for the decrease of calcification and degree of clinical function improvement.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.2
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• pp.77-83
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• 2014

Purpose: The purpose of current study was to evaluate the validity of the existing radiological classifications as a diagnostic modality for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint. For that purpose, we determined the inter-observer reliability for evaluating diagnostic precisions of the classification and also evaluated diagnostic accuracy of predicting the toothpaste type calcific deposition. Materials and Methods: We performed retrospective study with total 26 patients surgically treated with calcific tendinitis of the shoulder joint from March 2010 to October 2013. Two independent observers reviewed preoperative radiographs of shoulder joints, and classified the characteristics of calcific depositions according to the criteria of Gartner, DePalma and Patte. Cohen's kappa were calculated for each classifications to evaluate inter-observer reliability. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were determined for type of calcific depositions with Gartner type III, DePalma type I, and Patte type II for predicting toothpaste type calcific deposition. Results: The values of Cohen's kappa were the highest in the classification of Patte, 0.62, and the values for the classifications of DePalma and Gartner were 0.56 and 0.36, respectively. The sensitivities for predicting toothpaste type calcific deposition in Gartner Type III, DePalma type I and Patte type II were 83.3%, 91.7%, and 58.3%, respectively. Specificities were 85.7% 50.0% and 64%, positive likelihood ratios were 5.833, 1.833 and 1.633, negative likelihood ratios were 0.194, 0.167 and 0.648, and diagnostic odds ratios were 30.00, 11.00 and 2.52, respectively. Conclusion: There were no radiologic classifications of calcific tendinitis which has both high precision and accuracy. Further studies with other diagnostic modalities such as ultrasonography are needed for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.03a
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• pp.89-89
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• 2002

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.86-90
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• 2008

Purpose: To evaluate the differences between blindly and ultrasonography (US)-guided during multiple needling and dextrose injection technique for calcific tendinitis of shoulder. Materials and Methods: We chose 36 symptomatic calcific tendinitis patients, whose age ranged from 27 to 69. Our procedures were multiple needling and injection of dextrose over the lesion of calcific deposits. The bind injection group were 19 patients whose age ranged from 27 to 64-year-old (mean 52.2), and the US-guided injection group were 17 patients ranged from 31 to 69-year-old (mean 49.0). We compare these groups by VAS (visual analogue scale) and range of motion before and after procedures. Results: There is no difference between two groups in VAS and ROM before procedure (p>0.05). Two groups revealed significant improvement without limitation of shoulder function, however, the group under US-guided revealed better results than under blind (VAS:p=0.001, Flexion:p=0.000, Abduction:p=0.000, External rotation: p=0.016). Conclusion: Ultrasonography-guided procedure showed better results than blind, so the use of ultrasonography is more promising procedure.