Id 120
Topic Diagnostic & Practices
Main Speaker Arianna Pesaresi Italy
Co Speakers
Attendees
Extra Fees

This lecture focuses on the application of ultrasound-guided extracorporeal shock wave therapy (ESWT) in the treatment of calcific tendinopathy of the shoulder. Calcific tendinopathy is a common cause of shoulder pain and functional limitation, particularly in women aged 30 to 60 years. It is characterized by the deposition of hydroxyapatite crystals within the rotator cuff tendons, most frequently affecting the supraspinatus tendon. While ESWT has gained global recognition as a minimally invasive and conservative treatment for calcific tendinopathy, therapeutic outcomes may vary considerably in daily clinical practice. This variability is largely influenced by the phase of calcification, combined with tissue characteristics and the presence of concomitant conditions – all of which can be thoroughly assessed via diagnostic ultrasound (US). The following lecture will explore how US guidance can optimize ESWT efficacy by enabling personalized treatment protocols. In fact, diagnostic US offers comprehensive information on the size, consistency, and progressive phase of the calcification (formative, quiescent, or resorptive – according to the Uhthoff Cycle). Moreover, it detects associated comorbidities such as subacromial bursitis or joint effusion. These insights are critical in adapting ESWT parameters to the individual specific pathology and determining when adjunctive interventions are warranted to achieve satisfactory clinical results. Drawing on data from an observational retrospective study with prospective follow-up conducted in an Italian university hospital, the session will examine how US findings and proper ESWT application can correlate with clinical outcomes, as measured by validated tools like the Numeric Rating Scale (NRS), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Shoulder Pain and Disability Index (SPADI). Special attention will be given to the differential management of “hard” versus “soft” calcifications, with a focus on how deposits respond more favorably to ESWT in some specific phases of the calcification. Through real-world case presentations, participants will gain practical insights into the clinical decision-making process to gain proper treatment of both classic and challenging calcific tendinopathy cases. Key considerations will include strategies to prevent overtreatment, reduce complications, and enhance patient satisfaction by effectively incorporating US evaluation into routine clinical practice.