Correlation between aspiration of calcific rotator cuff tendinopathy and morphology on imaging.
Heidi Chen, Jennifer Cheng, Jefferson Tsai and 5 others
PMID 40008825WHAT IT FOUND
In 292 aspiration cases, 58.2% had calcium aspirated.
Type I x-ray calcifications and larger deposits were more likely to succeed; ultrasound morphology was not associated with success.
Key findings
01In 292 cases, 58.2% of aspirations were successful, defined as calcium entering the syringe.
02The Gärtner-Heyer x-ray classification was significantly associated with successful aspiration (p < .001); type II and type III had decreased odds compared with type I (64% and 91% decrease, p ≤ .003).
03Larger deposits were more likely to be aspirated: mean size was 16.7 ± 6.4 mm for successful versus 13.4 ± 7.5 mm for unsuccessful, and each 1-mm increase was associated with a 10% increase in odds of success (OR 1.10).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective and used chart notes, so technique details and classification errors may vary. There is no consensus on how to perform USPNA, and differences in technique may affect results. Success was defined only as calcium entering the syringe, not as pain relief or functional improvement. Gärtner-Heyer inter-rater agreement was fair before discussion and only moderate after clarification, so classification may differ between readers. Reliability testing used only 20 images, so the reliability estimates are based on a small subset. Patient-reported outcomes after aspiration were not assessed. The study included both acute and chronic cases, and symptom duration varied widely.
Declared interests
The supplied text lists NIH extramural research support. No conflict-of-interest declaration is provided.
The easy way to misread this
Do not read type I x-ray calcification as proof that aspiration will relieve pain or improve function. The study only defined success as calcium entering the syringe and did not assess patient-reported outcomes.