ABSTRACT
The authors report a case of inflammatory back pain associated with radiculopathy secondary to degenerative disk calcifications migrated within the foramen, epidural space and vertebral body. The purpose of this clinical case is to illustrate this uncommon cause of radiculopathy and avoid unnecessary invasive diagnostic procedures.
Subject(s)
Calcinosis/diagnosis , Intervertebral Disc Displacement/diagnosis , Intervertebral Disc/pathology , Osteoarthritis/diagnosis , Spondylitis/diagnosis , Thoracic Vertebrae/pathology , Back Pain/diagnosis , Epidural Space/pathology , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Radiculopathy/diagnosis , Spinal Canal/pathology , Tomography, X-Ray ComputedABSTRACT
PURPOSE: Extracorporal shock wave therapy has recently been proposed with good results (70%) for treatment of persistent painful calcifying tendinitis of the shoulder. The aim of this study was to evaluate the early impact of shock wave therapy on the anatomic structures of the shoulder. MATERIALS AND METHODS: Eight patients (7 women and 1 man, with mean age of 48 years) were prospectively followed up after undergoing shock wave therapy (1500 pulses with 0.28 mJ/mm2 energy). MRI (T1: 500/12 [TR/TE] and STIR: 7200/60/180/180 [TR/TE/TI/alpha]) were obtained 2 hours before and 15 days after the procedure; in addition for 5 of them one more examination was carried out 6 hours after extracorporal shock wave therapy. RESULTS: There was no significant signal change of the humeral bone or rotator cuff, and the calcification size, when seen (6 times), was unchanged at successive MR examinations. One patient had subcutaneous fat signal change (STIR) next to the zone of impact, which resolved 15 days after the extracorporal shock wave therapy. No bursitis or joint effusion was found. CONCLUSION: Shock wave therapy has no early complications or significant impact on the anatomic structures of the shoulder.
