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M u s c u l o s k e l e t a l I m a g i n g   •  V i d e o A r t i c l e

Musculoskeletal Ultrasound: How to Treat Calcific


Tendinitis of the Rotator Cuff by Ultrasound-Guided
Single-Needle Lavage Technique
Kenneth S. Lee1, Humberto G. Rosas

OBJECTIVE. The purpose of this video article is to illustrate is a common disabling cause of shoulder pain. Although most cases
the ultrasound appearance of calcium deposition in the rotator cuff are self-limiting, a subset of patients is refractory to conservative
and provide a detailed step-by-step protocol for performing the ul- therapy and requires treatment intervention. Ultrasound-guided la-
trasound-guided single-needle lavage technique for the treatment of vage is an effective and safe minimally-invasive treatment not read-
calcific tendinitis with emphasis on patient positioning, necessary ily offered in the United States as an alternative to surgery, perhaps
supplies, real-time lavage technique, and steroid injection into the because of the limited prevalence of musculoskeletal ultrasound pro-
subacromial subdeltoid bursa. grams and limited training. On completion of this video article, the
CONCLUSION. Musculoskeletal ultrasound is well established participant should be able to develop an appropriate diagnostic and
as a safe, cost-effective imaging tool in diagnosing and treating com- therapeutic algorithm for the treatment of calcific tendinitis of the
mon musculoskeletal disorders. Calcific tendinitis of the rotator cuff rotator cuff using ultrasound.

Keywords: calcific tendinitis, hydroxyapatite, lavage, shoulder, ultrasound


DOI:10.2214/AJR.10.4878
Received April 29, 2010; accepted without revision May 1, 2010.
1Both authors: Department of Radiology, Division of Musculoskeletal Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., E3/366 CSC,

Madison, WI 53792. Address correspondence to K. S. Lee (klee2@uwhealth.org).


WEB—This is a Web exclusive article. See http://ajronline.org/cgi/content/full/195/3/W213 for the video portion of this article.
AJR 2010; 195:W1 0361–803X/10/1953–W1 © American Roentgen Ray Society

638 AJR:195, September 2010

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