Disclosures: Heidi Chen, MD: No financial relationships or conflicts of interest

Objective: To assess if there is a correlation between the ability to aspirate calcific rotator cuff (RTC) tendinopathy and the morphology of the calcification on imaging studies

Design: Retrospective StudySetting : Academic CenterParticipants : 272 patients who underwent ultrasound-guided percutaneous needle aspiration (USPNA) of symptomatic calcific RTC tendinopathy from February 2016 to November 2020. Of these patients, 20 underwent procedures to bilateral shoulders, bringing total cases to 292.

Interventions: Data including patient demographics, medical history, x-rays, ultrasounds, and procedure details were obtained from electronic medical records. For each case, imaging was categorized using three morphological classifications. X-ray imaging utilized the Gartner-Heyer system (Type I to III) whereas ultrasound imaging was classified via Bianchi-Martinoli system (Type I to III) and Chiou system (arc, fragmented or punctuate, nodular, or cystic).

Main Outcome Measures: An overall percentage was calculated for successful and unsuccessful aspirations for morphological types within each classification system.

Results: Overall, 170 out of 292 (58.2%) aspirations were successful. When employing the Gartner-Heyer classifications, 92 out of 134 (55.1%) Type I calcifications, 65 out of 117 (38.9%) Type II calcifications, and 10 out of 35 (6.0%) Type III calcifications were successfully aspirated (p < 0.001). Three images were not able to be categorized. No statistical difference was appreciated when using the Bianchi-Martinoli (p=0.939) or Chiou (p=0.524) classification systems. The mean calcification size for successful aspirations was 16.7mm +/- 6.4mm which was significantly larger than that for unsuccessful aspirations (13.4 +/- 7.5mm; p < 0.001).Conclusions: Applying Gartner-Heyer classifications to radiographic data for RTC calcific tendinopathy may predict if a calcification can be successfully aspirated. In particular, Type I calcifications are aspirated at a greater rate than the other types. Larger calcification size may also predict if aspiration will be successful. These factors may improve patient selection for USPNA by predicting the success rate of the procedure and decreasing risk for patients by avoiding unnecessary procedures.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/correlation-between-aspiration-of-calcific-rotator-cuff-tendinopathy-and-morphology-on-imaging/