What is tendon calcification?
Tendon calcification occasionally occurs in the rotator cuff of the shoulder when the tendon has been injured. This may result in an area of calcium deposit causing pain and weakness of the tendon. Ultrasound guided aspiration of this calcium is a new procedure to try to remove the calcium without the need of a large incision and open surgery.

How is the procedure done?
An ultrasound machine is used to identify the calcification in the tendon. The skin is then sterilized with an alcohol-based solution, and local anesthetic is used to numb the skin. A needle is directed into the calcification under direct visualization using the ultrasound machine. Saline solution is injected into the area to wash the area and break up the calcium deposits. This saline is then aspirated to remove the calcium deposits.

Does the procedure hurt?
The procedure is relatively comfortable after the injection of the local anesthetic, but you will feel pressure as the saline is injected into the tendon.

How long does it take the treatment to work?
Most patients have some relief immediately, but complete resolution of pain takes several weeks as the body continues to dissolve the remaining calcium and heal the area that has been treated.

How long will it last?
In patients where the calcium is adequately removed, pain relief should be permanent. The calcium buildup does not usually return. A study of over 2000 patients presented at the Radiological Society of North America annual meeting in Chicago in 2007 showed that over 70% of patients had considerable reduction in pain and significant improvement in mobility of the affected limb after one year. 1

What should I expect after the injection?
When the local anesthetic wears off, it is common to feel discomfort in the tendon. This discomfort may be treated by applying an ice pack and by using acetaminophen or ibuprofen. For a number of days after the procedure, active non-weight bearing motion of the tendon is encouraged. Some patients benefit from 4-6 weeks of physical therapy.

What are the possible side effects?
Most calcium aspirations result in no side effects. The side effect of greatest concern is an infection of the deep tissues around the tendon.

1 Ultrasound-Guided Calcium Aspiration Sconfienza LM, Gravano M, Silvestri E, et al. Ultrasound guided percutaneous approach to the therapy of calcific tendonitis of rotator cuff. Presented at the Radiological Society of North America annual meeting. Nov. 25 30, 2007. Chicago.