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European Radiology
Published in: European Radiology 10/2016

Open Access 01-10-2016 | Musculoskeletal

Radiological and clinical predictors of long-term outcome in rotator cuff calcific tendinitis

Authors: Pieter Bas de Witte, Raymond A. van Adrichem, Jasmijn W. Selten, Jochem Nagels, M. Reijnierse, Rob G. H. H. Nelissen

Published in: European Radiology | Issue 10/2016

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Abstract

Objectives

Knowledge on the epidemiology and long-term course of rotator cuff calcific tendinitis (RCCT) is scarce. We assessed demographics, radiological characteristics, and their association with long-term outcomes in a large patient group.

Methods

Baseline demographics, radiological characteristics and treatment were recorded in 342 patients. Interobserver agreement of radiological measures was analyzed. Long-term outcome was evaluated with questionnaires (WORC, DASH). The association of baseline characteristics with outcome was assessed.

Results

Mean age was 49.0 (SD = 10.0), and 59.5 % were female. The dominant arm was affected in 66.0 %, and 21.3 % had bilateral disease. Calcifications were on average 18.7 mm (SD = 10.1, ICC = 0.84 (p < 0.001)) and located 10.1 mm (SD = 11.8) medially to the acromion (ICC = 0.77 (p < 0.001)). Gärtner type I calcifications were found in 32.1 % (Kappa = 0.47 (p < 0.001)). After 14 years (SD = 7.1) of follow-up, median WORC was 72.5 (range, 3.0-100.0; WORC < 60 in 42 %) and median DASH 17.0 (range, 0.0-82.0). Female gender, dominant arm involvement, bilateral disease, longer duration of symptoms, and multiple calcifications were associated with inferior WORC. DASH results were similar.

Conclusions

Many subjects have persisting shoulder complaints years after diagnosis, regardless of treatment. Female gender, dominant arm involvement, bilateral disease, longer duration of symptoms, and multiple calcifications were associated with inferior outcome. Radiological measures had moderate-to-good reliability and no prognostic value.

Key Points

• Most RCCT studies report on short-term outcome and/or small patients groups.
• In this large, long-term observational study, RCCT appeared to not be self-limiting in many subjects.
• Negative prognostic factors included female gender, more calcifications, dominant arm affected, and longer duration of symptoms.
• Interobserver agreement of general radiological RCCT measures is moderate to good.
• More rigorous diagnostics and treatment might be needed in specific RCCT cases.
Appendix
Available only for authorised users
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Metadata
Title
Radiological and clinical predictors of long-term outcome in rotator cuff calcific tendinitis
Authors
Pieter Bas de Witte
Raymond A. van Adrichem
Jasmijn W. Selten
Jochem Nagels
M. Reijnierse
Rob G. H. H. Nelissen
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4224-7

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