ULTRASOUND GUIDED LAVAGE OF THE CALCIFICATION

Calcifying tendinosis is a condition characterized by the accumulation of calcium in the tendons, most commonly in the rotator cuff. For now, the cause remains unknown. It mainly affects the active working population, most often women aged between 30 and 50 years. Although it sometimes does not manifest any clinical problems, it often causes pain and impaired shoulder joint mobility. Medication and physiotherapy are unsuccessful in a certain percentage of patients, thus requiring additional treatment (ultrasound-guided calcification, extracorporeal shock wave therapy (ESWT) or surgical treatment). This in most cases results in significant reduction or even elimination of symptoms.

Initially, the radiologist punctures the calcification under the ultrasound guidance. It is then rinsed with saline to remove it as much as possible. Following this procedure, an anti-inflammatory agent (corticosteroid) is injected in the subacromial bursa to prevent subacromial bursitis which can be a complication of the intervention itself. The aim of the treatment is to remove as much of the calcification as possible. Consequently, this reduces its volume effect causing subacromial impingement and inflammation of the tendon in which the calcification is located. In this way, clinical problems can be eliminated to the greatest possible extent.

The intervention is performed under the local anesthesia.

Together with the preparation, it lasts about 20 – 45 minutes.

Only mild forms of complications are known.

A vasovagal reaction may appear during or immediately after the treatment.

Within a few days or weeks after the intervention, subacromial bursitis may occur, manifested by recurring more pronounced shoulder pain. In such cases, treatment with anti-inflammatory tablets (non-steroidal anti-inflammatory drugs (NSAIDs)) is required. The other option is US-guided injection of an anti-inflammatory agent to the subacromial bursa.

The area of ​​intervention may get infected, but this is very rare.

There may be increased shoulder pain the first two days after the treatment. It is an adverse effect of the corticosteroid. An oral analgesic is recommended if this happens. Otherwise, the pain usually resolves by itself after a certain period.

During the first 14 days after the treatment, it is advised not to lift the arm above the shoulder girdle, or to stress the shoulder. After this period, the range of movements and loads can gradually begin to increase.

In diabetics, corticosteroid administration may cause blood sugar fluctuations for up to several days after the procedure. Therefore, more frequent measurements of sugar values ​​are advised.

In the case of swelling, redness and pain, or if there are symptoms of systemic infection (such as fever), medical attention is needed as soon as possible.

US examinations are performed exclusively on a self-pay basis.