Abstract
BackgroundThe purpose of the present study was to investigate the accuracy of Ultrasound (US), conventional X-Ray (CX) and Computed Tomography (CT) to estimate the total count, localization, morphology and consistency of Calcium deposits (CDs) in the rotator cuff.MethodsUS, CX and CT imaging was performed pre-operatively in 151 patients who underwent arthroscopic removal of CDs in the rotator cuff. In all procedures: (1) total CD counts were determined, (2) the CDs appearance in each image modality was correlated to the intraoperative consistency and (3) CDs were localized in their relation to the acromion using US, CX and CT.ResultsUsing US158 CDs, using CT 188 CDs and using CX 164 CDs were identified. Reliable localization of the CDs was possible with all used diagnostic modalities. CT revealed 49% of the CDs to be septated, out of which 85% were uni- and 15% multiseptated. CX was not suitable for prediction of CDs consistency. US reliably predicted viscous-solid CDs consistency only when presenting with full sound extinction (PPV 84.6%) . CT had high positive and negative predictive values for detection of liquid-soft (PPV 92.9%) and viscous-solid (PPV 87.8%) CDs.ConclusionUS and CX are sufficient for preoperative planning of CD removal with regards to localization and prediction of consistency if the deposits present with full sound extinction. This is the case in the majority of the patients. However, in patients with missing sound extinction CT can be recommended if CDs consistency of the deposits should be determined. Satellite deposits or septations are regularly present, which is of importance if complete CD removal is aspired.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-385) contains supplementary material, which is available to authorized users.
Highlights
The purpose of the present study was to investigate the accuracy of Ultrasound (US), conventional X-Ray (CX) and Computed Tomography (CT) to estimate the total count, localization, morphology and consistency of Calcium deposits (CDs) in the rotator cuff
Removal of the calcium deposits was possible through the lateral approach that was planned on the base of the Ogon sectors US in all patients
Intraoperative consistency of the CDs was viscous-solid in 72.8% and soft-liquid in 27.2%
Summary
The purpose of the present study was to investigate the accuracy of Ultrasound (US), conventional X-Ray (CX) and Computed Tomography (CT) to estimate the total count, localization, morphology and consistency of Calcium deposits (CDs) in the rotator cuff. Ultrasound (US) and Conventional X-Ray (CX) of the shoulder can be considered as standard modalities for diagnosing calcifying tendinitis of the rotator cuff. They are used for preparation of calcium deposit (CD) removal. Viscous-solid CDs have higher concentration of carbonate apatite and less liquids presenting like “toothpaste” after opening. Farin et al [4] reported computed tomography to add some information for CD characterization.
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