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Previous Volume 340:1533-1538 May 20, 1999 Number 20 Next

	Full Text PDF Editorial by Speed, C. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background and Methods Although ultrasound therapy is used to treat calcific tendinitis of the shoulder, its efficacy has not been rigorously evaluated. We conducted a randomized, double-blind comparison of ultrasonography and sham insonation in patients with symptomatic calcific tendinitis verified by radiography. Patients were assigned to receive 24 15-minute sessions of either pulsed ultrasound (frequency, 0.89 MHz; intensity, 2.5 W per square centimeter; pulsed mode, 1:4) or an indistinguishable sham treatment to the area over the calcification. The first 15 treatments were given daily (five times per week), and the remainder were given three times a week for three weeks. Randomization was conducted according to shoulders rather than patients, so a patient with bilateral tendinitis might receive either or both therapies.

Results We enrolled 63 consecutive patients (70 shoulders). Fifty-four patients (61 shoulders) completed the study. There were 32 shoulders in the ultrasound-treatment group and 29 in the sham-treatment group. After six weeks of treatment, calcium deposits had resolved in six shoulders (19 percent) in the ultrasound-treatment group and decreased by at least 50 percent in nine shoulders (28 percent), as compared with respective values of zero and three (10 percent) in the sham-treatment group (P=0.003). At the nine-month follow-up visit, calcium deposits had resolved in 13 shoulders (42 percent) in the ultrasound-treatment group and improved in 7 shoulders (23 percent), as compared with respective values of 2 (8 percent) and 3 (12 percent) in the sham-treatment group (P=0.002). At the end of treatment, patients who had received ultrasound treatment had greater decreases in pain and greater improvements in the quality of life than those who had received sham treatment; at nine months, the differences between the groups were no longer significant.

Conclusions In patients with symptomatic calcific tendinitis of the shoulder, ultrasound treatment helps resolve calcifications and is associated with short-term clinical improvement.

Source Information

From the Departments of Physical Medicine and Rehabilitation (G.R.E., C.B.E., P.N., G.F.W., E.P., V.F.-M.), Osteoradiology (M.A.F., F.K.), Traumatic Surgery (G.B.), Rheumatology (M.A.), and Angiology (M.B.), University Hospital of Vienna, Vienna, Austria; and the Forschungsinstitut für Balneologie und Kurortwissenschaft, Bad Elster, Germany (K.L.R.). Reinhard Weinstabl, M.D., Department of Traumatic Surgery, University Hospital of Vienna, Vienna, Austria, was also an author.

Address reprint requests to Dr. Ebenbichler at the Department of Physical Medicine and Rehabilitation, University Hospital of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria, or at gerold.ebenbichler{at}akh-wien.ac.at.

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