Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3772
Peer-review started: August 11, 2019
First decision: September 9, 2019
Revised: September 19, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 26, 2019
Processing time: 112 Days and 5.4 Hours
Calcific tendinopathy denotes calcific deposits in a specific tendon. It is also known as calcifying tendinitis, calcifying periarticulitis, or periarticular apatite deposition disease. Recently, extracorporeal shock wave therapy (ESWT) has been reported to be effective in relieving and treating pain in calcific tendinopathy.
A 36-year-old female patient suffered from left hip joint pain for six months. The pain was increased during abduction of the hip, waking, and jumping. B-mode ultrasonography was performed by a physiatrist with an L12-5 linear transducer. A single session of ESWT was given in the marking area under ultrasound guidance at 4 Hz, 2500 shots with intensity of stimulation using energy of 0.1 mJ/mm2. The hip pain of the patient slowly decreased within 4 wk after starting the ESWT. After six weeks of ESWT, her hip pain was completely resolved. However, the size of calcification showed almost no reduction in simple radiography at the final follow-up.
Ultrasonography is a very good modality not only for diagnosing calcified tendinitis by classical appearance, but also for evaluating the effect of ESWT during the follow-up period.
Core tip: As a feature of ultrasonography, high resolution shows the presence of deposits and defines their locations in the tendon, plus their size and texture. This technique enables staging of the deposits by correlation of shadow cones. In the resting phase, the deposits appear hyperechoic and arc shaped, whereas they appear non-arc shaped (fragmented/punctate and cystic) in the resolving phase. These appearances can also be correlated with the symptomatic and asymptomatic phases of the disease.