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M u s c u l o s k e l e t a l I m a g i n g V i d e o A r t i c l e

Musculoskeletal Ultrasound: How to Treat Calcific

Tendinitis of the Rotator Cuff by Ultrasound-Guided
Single-Needle Lavage Technique
Kenneth S. Lee1, Humberto G. Rosas
OBJECTIVE. The purpose of this video article is to illustrate
the ultrasound appearance of calcium deposition in the rotator cuff
and provide a detailed step-by-step protocol for performing the ultrasound-guided single-needle lavage technique for the treatment of
calcific tendinitis with emphasis on patient positioning, necessary
supplies, real-time lavage technique, and steroid injection into the
subacromial subdeltoid bursa.
CONCLUSION. Musculoskeletal ultrasound is well established
as a safe, cost-effective imaging tool in diagnosing and treating common musculoskeletal disorders. Calcific tendinitis of the rotator cuff

is a common disabling cause of shoulder pain. Although most cases

are self-limiting, a subset of patients is refractory to conservative
therapy and requires treatment intervention. Ultrasound-guided lavage is an effective and safe minimally-invasive treatment not readily offered in the United States as an alternative to surgery, perhaps
because of the limited prevalence of musculoskeletal ultrasound programs and limited training. On completion of this video article, the
participant should be able to develop an appropriate diagnostic and
therapeutic algorithm for the treatment of calcific tendinitis of the
rotator cuff using ultrasound.

Keywords: calcific tendinitis, hydroxyapatite, lavage, shoulder, ultrasound

DOI:10.2214/AJR.10.4878
Received April 29, 2010; accepted without revision May 1, 2010.
1Both authors: Department of Radiology, Division of Musculoskeletal Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., E3/366 CSC,

Madison, WI 53792. Address correspondence to K. S. Lee (klee2@uwhealth.org).

AJR 2010; 195:W213 0361803X/10/1953W213 American Roentgen Ray Society

AJR:195, September 2010

W213