Calcific Tendinitis Clinical Trial
Official title:
Treatment of Calcifying Tendinitis of the Shoulder: Ultrasound Guided Needling With Subacromial Corticosteroid Injection Versus Ultrasound Guided Subacromial Corticosteroid Injection Only, a Randomized Controlled Trial.
Ultrasound guided needling is becoming an accepted treatment for patients with shoulder pain due to calcifying tendinitis. However, evidence for this treatment is lacking. The investigators expect that patients treated with us guided needling with corticosteroid injection compared with patients treated with only corticosteroid injections in the subacromial bursa have better clinical outcome after one year follow-up.
Calcifying tendinitis of the shoulder is a common cause of shoulder pain with an incidence
ranging from 2.7 % to 6.8 %. This disease of the rotator cuff tendons is characterised by
calcifications in the tendons, most commonly in the supraspinatus tendon up to 82%. The
aetiology remains unclear.
Calcifying tendinitis is regarded as a self-healing condition with usually spontaneous
resolution of the calcifications. But some patients have chronic or recurrent pain and
disability of the shoulder which requires treatment. The treatment should be minimally
invasive and effective in short and long term. Symptomatic treatment is indicated first
using non-steroidal anti-inflammatory drugs, therapeutic exercise and non ultrasound guided
subacromial corticosteroids injection.
The role of corticosteroid injections is unknown due to the lack of good studies. Family
doctors and orthopaedic surgeons inject corticosteroids in the shoulder without the guidance
of ultrasound; with this method accurate needle placement in the subacromial bursa is not
possible. When this treatment fails other therapeutical methods can be used. Ultrasound
guided needling is a percutaneous technique of fragmentation or extraction of calcifications
in the rotator cuff tendon.
Literature shows favourable results but only a few randomized controlled trials were
executed. Randomised controlled trials are needed to give more insight in the effectiveness
of us guided needling. Comparing two groups of patients treated with us guided
corticosteroid injection and one group combined with us guided needling can provide
information of the usefulness of us guided needling.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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