Abstract
Aim To demonstrate the role of radiographs and ultrasound (USG) in the diagnosis of calcific
tendinitis and periarthritis in the wrist and hand and the efficacy of USG-guided
barbotage for its management.
Materials and Methods A retrospective chart review was performed in six patients who presented with acute-onset
pain in the wrist and hand varying from 3 days to 2 weeks. Four patients had tenderness
over pisiform and two patients had pain along the lateral aspect of the wrist and
thumb. Radiographs and USG revealed calcific focus corresponding to the site of pain.
USG-guided calcific barbotage and injection was performed for the same and pain relief
was assessed immediately and through telephonic follow-up at 6 months using subjective
satisfaction score. Data were analyzed using Microsoft Excel 2013.
Results Four patients with tenderness over pisiform had flexor carpi ulnaris calcific tendinitis
and two patients with pain along the lateral aspect of the wrist and thumb had first
metacarpophalangeal calcific periarthritis and abductor pollicis brevis calcific tendinitis
on radiographs as well as USG. In post-USG-guided calcific barbotage and injection,
all patients had significant immediate and 6 months delayed relief in symptoms with
excellent satisfaction scores.
Conclusion Acute calcific tendinitis/periarthritis is a benign and self-limiting inflammatory
condition. Radiographs are extremely helpful in identifying calcific focus. Ultrasonography
in experienced hands is the best modality to identify, confirm the symptomatic calcific
focus, and perform USG-guided intervention. USG-guided calcific barbotage is the simplest,
quickest, and effective way to treat this condition and avoid compromised functional
capacity.
Keywords barbotage - calcific - periarthritis - tendinitis - ultrasound
