Abstract | OBJECTIVES: We performed a systematic review of current evidence regarding ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) in the shoulder aimed to: assess different published techniques; evaluate clinical outcome in a large combined cohort; and propose suggestions for homogeneous future reporting. METHODS: Cochrane Collaboration for Systematic Reviews of Interventions Guidelines were followed. We searched MEDLINE/MEDLINE In-Process/EMBASE/Cochrane databases from 1992-2013 using the keywords 'ultrasound, shoulder, needling, calcification, lavage, rotator cuff' combined in appropriate algorithms. References of resulting papers were also screened. Risk of bias was assessed with a modified Newcastle-Ottawa Scale. RESULTS: Of 284 papers found, 15 were included, treating 1,450 shoulders in 1,403 patients (females, n = 838; mean age interval 40-63 years). There was no exclusion due to risk of bias. CONCLUSIONS: US-PICT of rotator cuff is a safe and effective procedure, with an estimated average 55% pain improvement at an average of 11 months, with a 10% minor complication rate. No evidence exists in favour of using a specific size/number of needles. Imaging follow-up should not be used routinely. Future studies should aim at structural uniformity, including the use of the Constant Score to assess outcomes and 1-year minimum follow-up. Alternatives to steroid injections should also be explored. KEY POINTS: • US-PICT of rotator cuff is a safe and effective procedure. • On average 55% pain improvement with 10% minor complication rate. • No evidence exists in favour of using a specific size/number of needles. • Future need to assess outcome using Constant Score with 1-year minimum follow-up.
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Authors | Ezio Lanza, Giuseppe Banfi, Giovanni Serafini, Francesca Lacelli, Davide Orlandi, Michele Bandirali, Francesco Sardanelli, Luca Maria Sconfienza |
Journal | European radiology
(Eur Radiol)
Vol. 25
Issue 7
Pg. 2176-83
(Jul 2015)
ISSN: 1432-1084 [Electronic] Germany |
PMID | 25583182
(Publication Type: Journal Article, Review, Systematic Review)
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Topics |
- Adult
- Calcinosis
(diagnostic imaging, therapy)
- Epidemiologic Methods
- Female
- Humans
- Male
- Middle Aged
- Needles
- Rotator Cuff
- Tendinopathy
(diagnostic imaging, therapy)
- Therapeutic Irrigation
(instrumentation, methods)
- Ultrasonography, Interventional
(instrumentation, methods)
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