Clinical and Radiological Outcomes of Ultrasound-Guided Closed-Circuit Irrigation of Calcific Tendinitis of the Shoulder: A Prospective Study

Ultrasound-guided percutaneous interventions are well-established as effective treatments for shoulder calcific tendinopathy. In this work, we modified the conventional double-needle approach by incorporating a closed-circuit irrigation system and assessed the procedure's clinical and radiological outcomes. We enrolled prospectively 24 patients (10 males; median age 54 years, IQR: 50-62) with painful calcific tendonitis of the shoulder between October 2023 and March 2024. All patients had a calcification > 5 mm treated with ultrasound-guided closed-circuit irrigation. Radiography, ultrasound evaluation, and OSS and SPADI clinical questionnaires were administered before the treatment and 3 months after. After the procedure, there was a significant reduction in the size of the calcifications (12 mm, IQR: 10-20 mm vs. 5.5 mm, IQR: 2-10 mm; <i>p</i> < 0.001). After the procedure, none of the patients experienced infections, while two developed bursitis. Three months after the procedure there were significant improvement in the OSS (16.5, IQR: 10-23 vs. 32, IQR: 36-45.5; <i>p</i> < 0.0001) and reduction in SPADI scores: pain (88, IQR: 74-95 before vs. 13, IQR: 4-24; <i>p</i> < 0.0001), disability (72, IQR: 60-90 before vs. 8, IQR: 4-20; <i>p</i> < 0.0001), and total score (78, IQR: 66-91 before vs. 11, IQR: 4-20; <i>p</i> < 0.0001). The closed-circuit double-needle irrigation for calcific tendinopathy of the shoulder is an effective treatment that improves both shoulder pain and function with a very low risk of short-term complications.