Shoulder complaints are one of the most common musculoskeletal complaints in general practice. Calcific tendinitis is a common cause of these shoulder complaints. This thesis focusses on the... Show moreShoulder complaints are one of the most common musculoskeletal complaints in general practice. Calcific tendinitis is a common cause of these shoulder complaints. This thesis focusses on the effectiveness of needle aspiration of calcific deposits (NACD), a treatment that is often performed in patients that do not respond well to conservative therapies such as NSAIDs, physiotherapy of subacromial injections with corticosteroids. During NACD, the calcific deposit is punctured and, if possible, aspirated using a needle under ultrasound guidance after which corticosteroids are injected into the subacromial bursa. Results of this thesis demonstrate that approximately 75% of patients are free of complaints six months after the procedure. However, in approximately one-third of patients, multiple procedures are required. A quick relief of complaints following the procedure is the most important prognostic factor for a good outcome in the longer term. Smoking, a longer duration of symptoms prior to the NACD procedure, requiring multiple NACD procedures and smaller-size calcific deposits affected the outcome negatively. Finally, the addition of platelet-rich plasma (PRP) to NACD proofed to have no additional benefits compared to conventional NACD with corticosteroid. In contrast, conventional NACD with corticosteroid provided a quicker relief of pain and improvement of shoulder function. Show less
