Acta clinica Croatica, Vol. 59. No. 2., 2020.
Original scientific paper
https://doi.org/10.20471/acc.2020.59.02.10
Calcific Tendinopathy: Calcium Deposit Morphology Directly Affects Pain and Function of the Shoulder
Gordana Cesarec
orcid.org/0000-0003-2859-5416
; Krapinske Toplice Special Hospital for Medical rehabilitation, Krapinske Toplice, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Sunčica Martinec
; Krapinske Toplice Special Hospital for Medical rehabilitation, Krapinske Toplice, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Nikola Čičak
; Akromion Special Hospital for Orthopedic Surgery, Krapinske Toplice, Croatia; School of Medicine, University of Split, Split, Croatia
Abstract
The aim of this study was to determine conventional ultrasonography characteristics of calcium deposits in patients diagnosed with calcific tendinopathy, to determine vascularization around deposits by power Doppler, and to compare morphological and power Doppler findings with
clinical findings by use of two questionnaires. Pain and function were evaluated using the visual analog scale and two questionnaires, Constant Shoulder Score and Oxford Shoulder Score. All subjects underwent ultrasonography examination and evaluation of vascularization (flow) along calcium deposit using power Doppler. Fifty-one subjects were included in the study. The χ2-test, a non-parametric
statistics method was used because of the categorical type of variables. The level of statistical significance was set at p<0.05. In the inactive phase, calcium deposit was shown as a hyperechoic focal point with dorsal acoustic shadow and negative power Doppler finding, whereas in the resorptive phase it appeared as fragmented irregular hyperechoic focal points with positive power Doppler findings. This study showed the patients with fragmented, cloudy calcification to have statistically significantly worse results on functional questionnaires and more positive power Doppler findings (grades II and III) and to experience stronger pain (visual analog scale 8-10). Upon defining the stage of calcific tendinopathy, the method of treatment can be determined and further course of the disease predicted. Defining the stage of calcification precisely helps avoid unnecessary and long-lasting physical therapy while introducing an effective treatment option, depending on the stage of the disease.
Keywords
Calcific tendinopathy; Shoulder; Morphology; Ultrasonography; Power Doppler
Hrčak ID:
243623
URI
Publication date:
1.6.2020.
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