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Extracorporeal shock wave therapy in calcific tendinitis of the shoulder

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Abstract

Objective

To investigate clinical (pain, mobility) and radiological (resolution of calcium deposits) efficacy of different energy levels of extracorporeal shock wave therapy (ESWT) in calcific tendinitis of the shoulder.

Design and patients

There were 90 study subjects with radiographically verified calcific tendinitis of one shoulder, mean age 52±6 years (range 29―65 years; females:males=55:35), all of whom had had symptoms for at least 6 months and substantial restriction of shoulder mobility and pain that required taking anti-inflammatory drugs. Calcium deposits were of type I or type II (clearly circumscribed and dense) and ranged from 1 cm to 3 cm in diameter. Subjects were divided into three groups to receive ESWT at one of two energy levels (E1=0.15 mJ/mm2, E2=0.44 mJ/mm2) or sham treatment. Treatment was given at 6 weekly intervals until symptoms resolved, five treatments had been given or the subject dropped out of the programme.

Results

All subjects in groups E1 and E2 completed the programme. Those in group E1 had significantly less pain during treatment but more treatments than those in group E2, and at 6 month follow-up had residual calcification and recurrence of pain (87%). Subjects in group E2 had no residual calcification or recurrence of pain. Sham treatment had no effect. There were no side effects except a small number of haematomas (2 in E1, 6 in E2; maximum size 2 cm).

Conclusion

ESWT in calcific tendinitis of the shoulder is very effective. It does not have significant side effects at an energy level of E=0.44 mJ/mm2, which can therefore be recommended.

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Acknowledgement

We should like to thank Prof. L. Zichner (Orthopedic Clinic Friedrichsheim in Frankfurt, Germany) for reviewing the manuscript and for his encouragement.

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Authors and Affiliations

  1. Department of Radiology, Bethanien Krankenhaus, Im Pruefling 23, 60389, Frankfurt am Main, Germany

    Jutta Peters

  2. Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany

    Jutta Peters, Wolfgang Luboldt, Wolfram Schwarz, Volkmar Jacobi, Christopher Herzog & Thomas J. Vogl

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  1. Jutta Peters
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  2. Wolfgang Luboldt
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  3. Wolfram Schwarz
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  4. Volkmar Jacobi
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  5. Christopher Herzog
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Correspondence to Jutta Peters.

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Peters, J., Luboldt, W., Schwarz, W. et al. Extracorporeal shock wave therapy in calcific tendinitis of the shoulder. Skeletal Radiol 33, 712–718 (2004). https://doi.org/10.1007/s00256-004-0849-8

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  • DOI: https://doi.org/10.1007/s00256-004-0849-8

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