THE PERCUTANEOUS ASPIRATION AND LAVAGE UNDER SONOGRAPHIC GUIDANCE: AN EFFECTIVE AND SIMPLE METHOD FOR THE TREATMENT OF THE ROTATOR CUFF CALCIFIC TENDINITIS, BASED ON AN EXPERIENCE OF 215 PROCEDURES

Purpose: To demonstrate the efficacy of the sonographic guidance for the percutaneous treatment of the rotator cuff calcific tendinitis.

Methods and Materials: During the five past years, 107 women and 69 men, presenting with a symptomatic calcific tendinitis of the rotator cuff have undergone 215 percutaneous aspiration and lavage under sonographic guidance: local anesthesia of the sub-acromial bursa with a 23 Gauge needle, needling and lavage of the calcification with a 16 Gauge needle, injection of a sterod in the bursa. The localization and the size of the calcium deposit, the duration of the procedure, if calcium was withdrawn or not, the short-term complications and clinical evolution were recorded.

Results: Localization: >90% in the supraspinatus tendon, size: 7–30mm, mean time: 15min, calcium withdrawn in 2/3 of the cases, rapidly decreasing symptoms and mobility improvement in one week for 80% of patients. Lavage was successful when the size of the calcification was >10mm. We had neither technical failure nor infectious complication.

Conclusions: The percutaneous aspiration and lavage of the symptomatic calcific tendinitis of the rotator cuff under sonographic guidance is simple and effective. Because of its advantages, no radiation, real-time guidance, shortest way to the target less traumatic for the tendon, direct visualization of the efficacy of the lavage, lower cost, this technique of guidance should be preferred to fluoroscopy and proposed in the early stage of the treatment of the symptomatic calcific tendinitis of the rotator cuff.