The role of high-resolution ultrasonography in management of calcific
Authors: Chiou H.-J.; Chou Y.-H.^1 ; Wu J.-J.; Huang T.-F.; Ma H.-L.; Hsu C.-C.; Chang C.-Y
References: Ultrasound in Medicine and Biology. Volume 27, Number 6, June 2001, pp. 735-743(9)
*/Objective./* To use color Doppler ultrasonography to evaluate^ the morphology and vascularity of calcific tendonitis and to^ predict the formative and resorptive phases of the calcification.^ */Methods./* Ninety-four patients with shoulder calcification on^ plain radiographs were enrolled in this study. Ultrasonography^ of the shoulder was focused on the rotator cuff. Color Doppler^ ultrasonography was applied in the calcific region. Patient^ symptoms were graded as painless, mild, moderate, and severe.^ The calcific plaques were classified as arc-shaped, fragmented^ or punctate, nodular, and cystic types. Color Doppler ultrasonographic^ signals were graded 0 to 3. The formative and resorptive phases^ of calcification were categorized by patient symptoms; acute^ onset of moderate or severe pain indicated the resorptive phase.^ */Results./* The calcific plaques appeared arc shaped in 59 patients^ (20 painless, 19 mild, and 20 moderate), fragmented or punctate^ in 27 (2 painless, 3 mild, 20 moderate, and 2 severe), nodular^ in 6 (1 moderate and 5 severe), and cystic in 2 (severe). There^ was a significant difference between the morphology of the calcific^ plaques and clinical symptoms (/P/ < .01). On color Doppler^ ultrasonography, grade 0 signals were found in 28 patients (22^ painless and 6 with mild pain); grade 1 in 18 (16 mild and 2^ severe); grade 2 in 41 (all moderate); and grade 3 in 7 (all^ severe). The correspondence between color Doppler ultrasonographic^ findings and clinical symptoms was excellent (/P/ < .01).
*/Conclusions./*^ High-resolution ultrasonography with color Doppler imaging could^ differentiate the formative and resorptive phases of the calcification and could be used as a follow-up modality in calcific tendonitis^ of the shoulder.