Miositis del subescapular. Una evolución infrecuente en la tendinopatía calcificada. Estudio de un caso / Subscapularis myositis: An uncommon complication in calcific tendinopathy. A case study

RESUMEN La tendinopatía calcificada del hombro se caracteriza por el depósito de cristales de hidroxiapatita en uno o varios tendones del hombro. Dentro de los procesos que ocurren en esta entidad está la fase de reabsorción, en la que los depósitos podrían migrar hacia estructuras adyacentes. Una muy rara complicación es la migración hacia la unión miotendinosa del tendón correspondiente, la cual provoca una importante reacción inflamatoria muscular que puede objetivarse en pruebas complementarias específicas. Presentamos un caso clínico de una tendinopatía calcificante del subescapular, con pos terior migración hacia la unión miotendinosa causando una miositis del mismo.

ABSTRACT Calcific tendinopathy of the shoulder is characterised by the deposit of hydroxy apatite crys tals in one or more tendons of the shoulder. Within the processes that occur within this disorder, there is the resorption phase, in which the deposits could migrate towards adjacent structures. A very rare complication is the migration towards the myotendinous junction of the corresponding tendon, which causes a significant muscular inflammatory reaction that can be seen in specific complementary tests. A clinical case is presented of a subscapular calcific tendinopathy, with subsequent migra tion to the myotendinous junction, causing myositis of the same.

Ultrasound-guided percutaneous needling and interventional therapy for rotator cuff calcific tendinopathy / 中国介入影像与治疗学

Objective: To explore the value of ultrasound-guided percutaneous needling and interventional therapy for rotator cuff calcific tendinopathy (RCCT).Methods: Ultrasound-guided percutaneous needling and intervention were performed on 31 patients diagnosed as simple RCCT. Then the follow-up was carried out after operation. Visual analogue scale (VAS) and Neer shoulder joint function score were observed before treatment, 1 month and 6 months after treatment to evaluate the degree of pain and the improvement of shoulder function, and statistical analysis was performed. Results: No adverse events such as treatment-related infection and tendon injury occurred among 31 patients. There was no statistical difference of VAS before and 1 month after treatment compared with that before treatment (P=0.412). However, VAS separately decreased 6 months after treatment compared with that before and 1 month after treatment (both P<0.001). Neer shoulder function scores were significantly improved 1 month and 6 months after treatment compared with that before treatment (both P<0.001). In addition, Neer shoulder joint function score of 6 months after treatment was significantly higher than that 1 month after treatment (P<0.001). Conclusion: Ultrasound-guided percutaneous needling and interventional therapy for RCCT is effective, non-ionizing, minimally invasive and safety.

Calcific Tendinopathy of the Gluteus Medius Mimicking Lumbar Radicular Pain Successfully Treated With Barbotage: A Case Report

We report a case of calcific tendinopathy of the gluteus medius initially misdiagnosed as a lumbar herniated intervertebral disc. It was successfully treated with barbotage under ultrasonographic guidance finally. A 56-year-old woman was referred to interventional pain clinic for right hip pain due to an L5-S1 disc herniation. Serial L5 and S1 spinal nerve root blocks and epidural steroid injections were administered. However, pain relief was sustained only for a very short period. Plain radiography of the right hip revealed a solid calcific nodule at adjacent to the insertion site of the gluteus medius tendon. Physical modalities and extracorporeal shock wave therapy failed to improve the pain. Therefore, we attempted ultrasound-guided barbotage of the calcification. Barbotage was performed twice serially and her pain was considerably improved. At 6-month follow-up, the calcification was completely resolved.