P B de Witte1, R A van Adrichem, J W Selten, J Nagels, M Reijnierse, R G H H Nelissen. 1. *Dit onderzoek werd eerder gepubliceerd in European Radiology (2016;26:3401-11) met als titel 'Radiological and clinical predictors of long-term outcome in rotator cuff calcific tendinitis'. Afgedrukt met toestemming.
Abstract
OBJECTIVE: We assessed the most important demographics and radiological characteristics at the time of diagnosis of rotator cuff calcific tendinitis (RCCT), and their associations with long-term clinical outcome. DESIGN: Observational study. METHOD: Baseline characteristics and treatment were evaluated in 342 patients in whom RCCT had been diagnosed. Interobserver agreement of the radiological investigations was analysed. Patients were sent a general questionnaire and 2 shoulder questionnaires, the "Western Ontario rotator cuff" (WORC) and the "Disabilities of the arm, shoulder and hand" (DASH) for evaluation of long-term clinical outcome. Associations between baseline characteristics and long-term outcomes were analysed using logistic regression. RESULTS: Mean age at diagnosis was 49.0 years (SD = 10.0), and 60% were female. The dominant arm was affected in 66%, and 21% had bilateral RCCT. Calcifications were on average 18.7 mm in size (SD = 10.1, ICC = 0.84 (p < 0.001)) and located 10.1 mm (SD = 11.8) medially to the acromion (ICC = 0.77 (p < 0.001)). 32% of the calcifications had a Gärtner type I classification (κ: 0.47 (p<0.001)). After a mean follow-up of 14 years (SD =7.1), median WORC score was 72.5 (range: 3.0-100.0) and median DASH score 17.0 (range: 0.0-82.0). Female gender, dominant arm involvement, bilateral disease, longer duration of symptoms at presentation, and presence of multiple calcifications were associated with inferior long-term outcomes. CONCLUSION: RCCT is not self-limiting. Radiological variations have no significant predictive value. We identified specific prognostic factors for inferior long-term outcome; more intensive follow-up and treatment should be considered in patients with these characteristics.
OBJECTIVE: We assessed the most important demographics and radiological characteristics at the time of diagnosis of rotator cuff calcific tendinitis (RCCT), and their associations with long-term clinical outcome. DESIGN: Observational study. METHOD: Baseline characteristics and treatment were evaluated in 342 patients in whom RCCT had been diagnosed. Interobserver agreement of the radiological investigations was analysed. Patients were sent a general questionnaire and 2 shoulder questionnaires, the "Western Ontario rotator cuff" (WORC) and the "Disabilities of the arm, shoulder and hand" (DASH) for evaluation of long-term clinical outcome. Associations between baseline characteristics and long-term outcomes were analysed using logistic regression. RESULTS: Mean age at diagnosis was 49.0 years (SD = 10.0), and 60% were female. The dominant arm was affected in 66%, and 21% had bilateral RCCT. Calcifications were on average 18.7 mm in size (SD = 10.1, ICC = 0.84 (p < 0.001)) and located 10.1 mm (SD = 11.8) medially to the acromion (ICC = 0.77 (p < 0.001)). 32% of the calcifications had a Gärtner type I classification (κ: 0.47 (p<0.001)). After a mean follow-up of 14 years (SD =7.1), median WORC score was 72.5 (range: 3.0-100.0) and median DASH score 17.0 (range: 0.0-82.0). Female gender, dominant arm involvement, bilateral disease, longer duration of symptoms at presentation, and presence of multiple calcifications were associated with inferior long-term outcomes. CONCLUSION: RCCT is not self-limiting. Radiological variations have no significant predictive value. We identified specific prognostic factors for inferior long-term outcome; more intensive follow-up and treatment should be considered in patients with these characteristics.