Author: M. Pinho Teixeira Alves
Institution: HOSPOR - Santiago Hospital, Department of Orthopaedics, SetObal, Portugal
The author will present the preliminary results of his study on the treatment of shoulder periarticular calcification with extracorporeal shock waves.
Fourteen patients suffering from subacromiol impingement syndrome, with radiographic evidence of calcification inside the supraspinatus tendon and subacromial bursa, were studied. All patients were submifted to musculoskeletal echography in order to exclude rotator cuff tears. All patients presented with a painful reduction of shoulder range of motion, especially abduction and external rotation. Nocturnal pain was found in all patients. the analogic pain scale was used to evaluate the patients's pain. The treatment consisted of three sessions of extracorporeal shock waves (power of 0.2 mJ/mm2 - 11,2 K'v, one per week, each session of 2000 shots, in a 120 shockwaves per minute frequency. The equipment used was Siemens LithostarUro ®, with Siemens Siremobil Image Intensifier ® and Siemens Adara Echograph ®.
Follow up in two weeks after treatment and two months later showed in 86% of cases a reduction of pain and increase of shoulder range of motion. The nocturnal pain disappeared in 86% of patients. The analogue pain scale improved from a medium of 7 to 1,5. One patient (7%) abandoned the treatment. One patient (7%) was submifted to surgical treatment. X-rays two months after treatment showed a initial fragmentation of calcification in one case (there was a 1 ,5 cm calcification) and total resorption in the other cases, with smaller calcifications.
The author considers the technique a valid treatment method of subacromial impingement syn drome with periorticu ar shoulder calcifications.

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