Efficacy and Tolerance of Ultrasound-guided Needling and Lavage of Calcific Tendinitis of the Rotator Cuff Performed With or Without Subacromial Corticosteroid Injection

Nantes University Hospital136 enrolled

Overview

Calcific tendinitis of the rotator cuff is a common cause of chronic pain of the shoulder. Needling and lavage of the calcification is one of the therapeutic options after failure of conservative management with physiotherapy and anti-inflammatory drugs. Needling is usually followed by a corticosteroid injection in the subacromial bursae in order to prevent acute pain reaction due to the intervention. However, the relevance of this injection has never been proven. Moreover, corticosteroid could prevent the inflammatory reaction induced by the needling and thus the body's natural calcium resorption processes. Finally, corticosteroids could have deleterious effect on the tendon structures and favour local infection. Our hypothesis is that corticosteroid have no significant effect on acute pain after needling and therefore should not been performed systematically after needling.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

136

Conditions

Calcifying Tendinitis of Shoulder

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Shoulder pain for at least 3 month * Positive Hawkins, Yocum and/or Neer test for impingement * Calcific deposit \>= 5 mm on shoulder x-ray in one the tendon of the rotator cuff Exclusion Criteria: * Allergy to lidocaïne or methylprednisolone acetate * Acute pain suggestive of resorption of the calcification with ill-defined - calcification on X-Ray * Other shoulder diseases : ostearthritis of the gleno-humeral or acromio-clavicular joint * Sonographic findings of rotator cuff tear * Subacromial steroid injection in the previous month * Uncontrolled diabetes * Pregnant women * Contraindication for the use of nonsteroidal antiinflammatory drugs or paracetamol/acetaminophene

Locations (3)

La Roche sur Yon Hospital

La Roche-sur-Yon, France

Nantes University Hospital

Nantes, France

Rennes University hospital

Rennes, France

Outcomes

Primary Outcomes

Maximum pain (VAS scale)

Maximum pain on a VAS scale (0-10) reported by the patient in the seven days following the needling.

Time frame: 7 days

Secondary Outcomes

Anti-inflammatory and analgesic intake

Time frame: 7 days

Size of the calcific deposit

Time frame: 7 days

Size of the calcific deposit

Time frame: 3 months

Size of the calcific deposit

Time frame: 12 months