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Tendon Calcification Therapy

Calcium can often build up in tendons and tissues near a joint, which causes pain and makes movement difficult. Treating this calcium can help permanently reduce pain. We use ultrasound to localize the deposit and remove the calcium with a needle.

After the treatment, a local steroid is injected to reduce inflammation. We arrange a follow-up ultrasound six months after your treatment for re-assessment, and to plan additional procedures if required. Calcium deposits must meet specific size criteria to be amenable to this procedure. We advise a diagnostic bursal steroid injection before this procedure is considered.

During your procedure, we have treated your calcium and encouraged your body to resorb any residual calcium causing your pain. This make take 2-4 weeks to take full effect. 

HOW DO I PREPARE FOR MY PROCEDURE?

  • Arrive 15 minutes prior to your appointment.
  • Wear comfortable clothing.
  • Prior to your injection, you must have an ultrasound and X-ray of the area of concern.
  • For calcium in the shoulder tendons, we advise a conservative approach with an initial steroid injection to the bursa. This may be adequate to treat the symptoms.

WHAT HAPPENS DURING MY PROCEDURE?

  • We may provide you with a comfortable clinic gown to change into (depending on the area being treated).
  • A team member will explain the consent form, procedure details, and answer any questions.
  • We will then escort you to our treatment suite where you will meet the radiologist who will clean the skin and inject a local anesthetic, similar to the freezing you get at the dentist.
  • Ultrasound will be used to guide the needle into the area of interest. Once in position the radiologist will attempt to extract or aspirate the calcium deposit from the affected tendon and an anti-inflammatory may then be injected.
  • Any remaining calcium deposits will be gradually re-absorbed by your body.
  • You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

  • First 24 hours: Keep the treatment area clean. Leave the Band-Aid on. Do not shower
  • First 48 hours: Avoid bathtubs, hot tubs, and pools. Avoid strenuous activities and lifting. The pain may temporarily worsen due to inflammation during the first 24-48 hours. Take Tylenol, aspirin, ibuprofen, and apply heat or cold as needed.
  • After one week: You may gradually return to activity and resume physiotherapy. Be mindful of your pain and stop if it hurts too much. Notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
  • Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.
  • If you have pain or other symptoms beyond 48 hours after your injection, please call our office at 403-568-3890 or email us at paintherapy@radiology.ca during business hours. You may apply heat and ice to the treatment area.
  • Diabetics: Note that cortisone can cause a temporary increase in blood sugar. Please monitor your blood sugar closely and if you have any concerns, consult with your doctor.
  • Anti-coagulant therapy: You will be directed when to resume any anti-coagulant (blood thinners) medication.

WHEN WILL I SEE RESULTS?

  • During your procedure, we have treated your calcium and encouraged your body to resorb any residual calcium causing your pain. This may take 2-4 weeks to take full effect.
  • We will arrange a follow-up ultrasound in six months to assess your response to this treatment. At that time, you will be asked about your level of activity, range of motion, and pain score to determine the effectiveness of the treatment and guide further management.
  • If your symptoms recur before your follow-up ultrasound, a bursal steroid injection may be considered.
  • If an injection does not help relieve your symptoms, then you may need further evaluation by your referring doctor for another cause of your symptoms.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinic.

 

FOR YOUR APPOINTMENT

Please ensure that you bring your requisition with to your appointment.


DURATION

30 minutes

FREQUENTLY ASKED QUESTIONS

How long does the procedure take to work?

During your procedure, we have treated your calcium and encouraged your body to resorb any residual calcium causing your pain. This may take 2-4 weeks to take full effect.

How long will the treatment last?

We will arrange a follow-up ultrasound in six months to assess your response to this treatment. At that time, you will be asked about your level of activity, range of motion, and pain score to determine the effectiveness of the treatment and guide further management. If your symptoms recur before your follow-up ultrasound, a bursal steroid injection may be considered. If an injection does not help relieve your symptoms, then you may need further evaluation by your referring doctor for another cause of your symptoms.

How many procedures can I have and how often?

We will arrange a follow-up ultrasound to re-assess the tendon after six months to ensure the calcium is reabsorbing and your symptoms are improving. Rarely, a repeat procedure will be recommended. If your pain persists, a repeat bursal steroid injection may be considered at six weeks post-treatment.

What are the side effects?

A common side effect of the procedure is mild pain or bruising around the area. Over-the-counter pain medication or icing the area can help. Very rare side effects may include infection or tearing of the tendon.