Long-term results of radiotherapy for periarthritis of the shoulder: a retrospective evaluation

Marcus Niewald,Jochen Fleckenstein,Susanne Naumann,Christian Ruebe

doi:10.1186/1748-717x-2-34

Abstract

BackgroundTo evaluate retrospectively the results of radiotherapy for periarthritis of the shoulderMethodsIn 1983–2004, 141 patients were treated, all had attended at least one follow-up examination. 19% had had pain for several weeks, 66% for months and 14% for years. Shoulder motility was impaired in 137/140 patients. Nearly all patients had taken oral analgesics, 81% had undergone physiotherapy, five patients had been operated on, and six had been irradiated. Radiotherapy was applied using regular anterior-posterior opposing portals and Co-60 gamma rays or 4 MV photons. 89% of the patients received a total dose of 6 Gy (dose/fraction of 1 Gy twice weekly, the others had total doses ranging from 4 to 8 Gy. The patients and the referring doctors were given written questionnaires in order to obtain long-term results. The mean duration of follow-up was 6.9 years [0–20 years].ResultsDuring the first follow-up examination at the end of radiotherapy 56% of the patients reported pain relief and improvement of motility. After in median 4.5 months the values were 69 and 89%, after 3.9 years 73% and 73%, respectively. There were virtually no side effects. In the questionnaires, 69% of the patients reported pain relief directly after radiotherapy, 31% up to 12 weeks after radiotherapy. 56% of the patients stated that pain relief had lasted for "years", in further 12% at least for "months".ConclusionLow-dose radiotherapy for periarthropathy of the shoulder was highly effective and yielded long-lasting improvement of pain and motility without side effects.

Highlights

To evaluate retrospectively the results of radiotherapy for periarthritis of the shoulder
Radiotherapy for benign diseases was widely accepted in Germany, Switzerland and Austria, while these techniques were rarely utilized in other West European countries for fear of an elevated frequency of secondary malignancies [3,4]
In our series all patients had been diagnosed with a calcifying periarthritis humeroscapularis (PHS)

Summary

Introduction

To evaluate retrospectively the results of radiotherapy for periarthritis of the shoulder. In general inflammatory or degenerative disorders of the joints or the surrounding tendons are treated with very low total doses of ionizing radiation in order to achieve pain relief and improvement (page number not for citation purposes). Periarthritis of the shoulder is a rather frequent disease belonging to this group. In the last ten years the general periarthritis humeroscapularis (PHS) has been subdivided into several syndromes. According to the classification published by Hedtmann et al [7] a simple, an adhesive, a calcifying, and a destructive PHS should be distinguished. In our series all patients had been diagnosed with a calcifying PHS (calcific tendinosis or tendinitis)

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