Value of preoperative ultrasound marking of calcium deposits in patients who require surgical treatment of calcific tendinitis of the shoulder

Arthroscopy. 2007 Jan;23(1):43-50. doi: 10.1016/j.arthro.2006.08.005.


Purpose: The objective of our study was to evaluate whether preoperative ultrasound-guided marking of calcium deposits has a positive effect on the efficiency and speed of localization of calcium deposits during surgery, and whether this technique is a factor that increases the probability of good clinical results.

Methods: Twenty-four patients who required surgery for calcific tendinitis in the years 2001 and 2002 were divided into 2 groups of 12 patients by week. Before undergoing surgery, those in group 1 (weeks 1, 3, 5, etc.) were given a standard ultrasound examination, along with preoperative ultrasound-guided marking (pre-USM) of calcium deposits, whereas group 2 (weeks 2, 4, 6, etc.) received the standard ultrasound examination without pre-USM. In both groups, arthroscopic removal of calcium deposits was carried out and the postoperative treatment plan was identical. The clinical result was evaluated by the Constant-Murley score.

Results: At the 6-week and 2-year follow-up visits, the clinical result was significantly better (P < .05) in the pre-USM group than in the unmarked group (Constant score of 76 v 70 points and 80 v 74 points, respectively). After 12 weeks, the clinical outcomes of both groups showed an approaching significance, with better results seen in the pre-USM group (79 v 74 points; P = .052). The time required for intraoperative localization of calcium deposits was 16 versus 22 minutes. The difference showed an approaching significance (P = .057). Removal of calcium was possible in 12 versus 10 cases; complete removal was possible in 8 versus 6 cases, respectively. However, none of these variables had a statistically significant influence on our results.

Conclusions: Preoperative ultrasound-guided marking of calcific deposits is a procedure that statistically significantly improves the clinical results of arthroscopic surgery as seen at 6 weeks and 2 years; statistical significance of .052 was approached only at 12 weeks, as we have shown here for calcifying tendinitis of the shoulder joint.

Level of evidence: Level III, development of diagnostic criteria with nonconsecutive patients.

MeSH terms

  • Adult
  • Arthroscopy / methods
  • Calcinosis / diagnostic imaging*
  • Calcinosis / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Posture
  • Preoperative Care*
  • Rotator Cuff / diagnostic imaging*
  • Sensitivity and Specificity
  • Shoulder Joint / diagnostic imaging*
  • Shoulder Joint / surgery
  • Tendinopathy / diagnostic imaging*
  • Tendinopathy / surgery*
  • Ultrasonography