In general, surgery is recommended for calcificated tendinitis of the shoulder if the patients have symptoms after conservative treatments, including needle aspiration and physical therapy. Many researchers agree about the need for adequate physical therapy consisting of range of motion exercise, muscle strengthening exercises and electrophysical agents. Some researchers report that ultrasound (US) promotes angiogenesis and calcium uptake to fibroblasts, but there are few studies about u/s effects on calcificated tendinitis of the shoulder. The purpose of this study was to evaluate the US therapy effect on calcification, pain during active movement, and to identify factors related to improvement in a randomised controlled fashion. We used the stratified random allocation method to assign 40 consecutive patients to experimental and control groups, so each group consisted of 20 patients. The experimental group was treated by US therapy and therapeutic exercises, and the control group was treated with therapeutic exercises only. All patients in both groups came to our department 3 times per week and US therapy was performed 3 times per week until the end of the study. First, we classified the calcification as type I (clearly circumscribed and with dense appearance on radiography), type II (dense or clearly circumscription) and type III (translucent or cloudy appearance without clear circumscription) according to the classification of Gartner and Heyer. Radiography was performed every one month, and in the main outcome measure was the change from the base-line of the calcification on radiography at the end of the treatment. The three point scale of Gartner and Heyer was used, in which 50% in the area and density of the calcification, and a score of 3 a complete resolution of the calcification. We also examined the affected shoulders for presence or absence of pain in active movement at the start and at the end of the study. The calcifications improved significantly and fewer patients had pain during active movement in the experimental group. There was a statistical significant disease duration difference from the first clinical presentation between scores 2 and 3 in the experimental group. The results of this study suggest that US therapy helps to resolve calcification of shorter disease duration. Calcifications of longer disease duration tended to persist in spite of US therapy, but we thought treatment of 27 to 28 times (95% CI), until score 2 was attained, was a desirable strategy.

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