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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 December;62(6):435-42
Efficacy of ultrasounds in class E in scapulohumeral periarthritis
Brunello E., Bissoli L., Gallo P., Cantamessa G.
Studio Prof. A. Squassabia Radiologia e Terapia Fisica s.a.s., Verona, Italia
AIM:The aim of our study was to evaluate the therapeutic efficacy of ultrasounds in class E (USE) in calcific periarthritis of the shoulder (scapulohumeral periarthritis), in terms of both pain reduction and an improvement of the ROM and the resulting functionality, and finally in terms of instrumentally proven reduction of the diameter of the calcifications.
METHODS: In the period September 2009-September 2010, we recruited 12 subjects of both sexes, average age 52.67 years with a diagnosis of calcific periarthritis of the shoulder performed using clinical examination and imaging techniques (radiography, ultrasound and/or MRI). The diagnosis preceded the study by a minimum period of 1 month and a maximum of 72, with an average of 13 months.
RESULTS: Of the 12 patients treated, 11 showed a significant decrease in subjective pain measured by VAS; 75% of patients also showed a disappearance of the calcifications radiologically and/or sonographically documented 3 months after treatment. Only one patient did not benefit either subjectively or from the clinical trials of the treatment performed, corresponding to a percentage of 8.3% of the cases treated. The analgesic effect and break-up of the calcifications are the result of the direct mechanical effect and cavitation effect produced by the USE used. The only patient who did not subjectively benefit from the treatment does not seem to bring discouraging data as this was the only case in which the scapulohumeral periarthritis had been diagnosed 72 months before, a much longer period compared to the average of the other patients in the study (13 months).
CONCLUSION:The significant reduction of the VAS and the consequent recovery of the joint ROM in the other 11 cases, with improvement in clinical trials in patients until that point irresponsive to the most common non-invasive treatments using standard physical therapy, encourages new studies on the possible use of this method in treating scapulohumeral periarthritis, further underpinned by the disappearance of calcifications, radiologically and sonographically documented, in 75% of cases.